Director of Wound Care

Director of Wound Care and Restorative Nursing

Facility: 120 bed skilled nursing facility Department: Nursing Reports To: Director of Nursing Supervises: Restorative Aides (direct); provides clinical direction to licensed nursing staff on wound and restorative practice (indirect)
Status: Full time, salaried. Classification as exempt or nonexempt should be confirmed with your HR partner or employment counsel based on actual duties performed.
Schedule: Primarily days, Monday through Friday, with availability for weekend and after hours consultation on new admissions, acute skin changes, and survey activity.

The Director of Wound Care and Restorative Nursing owns two clinical programs that share the same underlying goal: keeping residents intact and functional. On the wound side, this position leads prevention, assessment, treatment, and documentation for all skin and wound conditions in the building. On the restorative side, this position designs, staffs, and monitors the formal restorative nursing program that maintains or improves resident function after skilled therapy ends.

This is a program leadership role, not a treatment cart role. The person in this seat is accountable for outcomes, documentation defensibility, regulatory readiness, and staff competency, and they are expected to be visible at the bedside every single day.

This position is designated as a program role. The incumbent is not counted in daily direct care staffing ratios and is not routinely assigned to a hall or med cart. Emergency staffing coverage requires approval from the Director of Nursing or Administrator, should be documented, and should be the exception rather than the operating plan. Both programs collapse quickly when program leadership is repeatedly pulled to fill floor gaps, and both programs carry regulatory and reimbursement consequences when they collapse.

• Perform a complete skin assessment on every new admission and readmission within the facility required window, and document findings before the end of the shift on which the resident arrives.

• Conduct weekly assessment and measurement of all open wounds, including length, width, depth, undermining, tunneling, wound bed characteristics, exudate, periwound condition, odor, and pain.

• Stage pressure injuries in accordance with current National Pressure Injury Advisory Panel definitions, and correctly differentiate pressure injuries from moisture associated skin damage, skin tears, arterial and venous ulcers, diabetic foot ulcers, and other non pressure lesions.

• Determine and document whether each pressure injury was present on admission or acquired in the facility, and initiate immediate review of every facility acquired pressure injury.

• Develop and revise individualized treatment orders in collaboration with the attending physician, nurse practitioner, or wound physician, and ensure orders are transcribed accurately into the electronic health record.

• Coordinate wound consults, vascular studies, debridement services, negative pressure wound therapy, and specialty referrals, and track that recommendations are implemented.

• Round with the visiting wound physician or consultant and translate consult recommendations into actionable, transcribed orders the same day.

• Serve as the clinical resource for complex or nonhealing wounds, including escalation to the Director of Nursing and Medical Director when a wound fails to progress within an expected timeframe.

• Own the pressure injury prevention program, including risk assessment on admission, weekly during the first four weeks, quarterly, and with significant change in condition.

• Direct the support surface and pressure redistribution program, including mattress and cushion selection, inventory, and verification that the ordered surface is actually in place and functioning.

• Verify turning and repositioning compliance through direct observation, not chart review alone.

• Partner with the Registered Dietitian on nutritional risk, weight loss, hydration, protein needs, and supplementation for residents at risk of or with existing skin breakdown.

• Partner with Therapy on seating, positioning, contracture management, offloading devices, and safe mobility for residents with wounds.

• Ensure wound documentation is complete, consistent between the treatment record, nurses notes, care plan, and MDS,…