Director of Nursing RN Home Health Family Owned Agency

We are a family-owned home health agency in San Antonio with over 30 years of experience, and we are looking for a Director of Nursing who wants to lead a clinical team the right way — with real authority, real support, and an agency that has its house in order.

This is not a turnaround job. You are not walking into a mess.

We have two consecutive deficiency-free state surveys, patient satisfaction scores of 93% against a Texas average of 63%, and a physician referral network built over three decades in this community. You are inheriting a functioning agency with an experienced office team — and the room to make it even better.

Most DON roles ask one person to be everything: clinician, compliance officer, coder, biller, scheduler, and HR. That is why most DONs burn out.

Here, you have a team around you:

• A Director of Operations who owns billing, authorizations, and day-to-day operations
• A QA nurse with 20 years at this agency who handles chart review and OASIS quality
• Outsourced coding and QA support so you are not personally coding every chart
• A dedicated intake and scheduling coordinator
• An alternate supervising nurse for coverage
• A modern EMR (Well Sky) with mobile point-of-care charting

Your job is clinical leadership — not doing everyone else's job at 9 p.m.

We run on Well Sky Sky Sense, and we're rolling out AI documentation tools to our field team — including ambient AI that helps draft visit notes. We're one of the first agencies in San Antonio putting this in our nurses' hands.

Behind the scenes, we also use AI-assisted chart review and audit-defense tools to catch documentation gaps before they become denials or survey findings. That means you're not personally reading 40 charts on a Saturday to find the one problem.

If you've spent years at agencies running on outdated software and manual chart audits, this will be a different experience. We'd rather spend money on better tools than burn out good nurses.

• Clinical oversight of all patient care services and personnel under the Medicare Conditions of Participation
• Plan of care review and approval, coordination of care, and case conferences
• Supervision and development of field RNs and LVNs
• OASIS accuracy, timely transmission, and outcome improvement
• QAPI program leadership
• Survey readiness and regulatory compliance (Medicare CoPs, Texas HCSSA)
• Partnering with the Administrator and Director of Operations on growth and quality strategy

We are direct about this, because it matters more to us than anything else on your resume:

Our field staff are experienced professionals. The right person for this role gives clear expectations, coaches in private, gives credit in public, and knows the difference between holding a standard and making someone feel small. If a nurse makes a documentation error, we want them taught — not embarrassed.

You will have full authority to set clinical standards here. We will back you up. In exchange, we expect the people who work under you to want to keep working here.

If you are clinically strong and people genuinely like working for you, you are exactly who we are looking for — and you already know how rare that combination is.

• Active Texas RN license (BSN preferred)
• Home health experience required — Medicare-certified home health specifically
• Prior DON, Assistant DON, Clinical Manager, or clinical supervisory experience
• Working knowledge of the Medicare Home Health Conditions of Participation
• OASIS-E competency
• Experience with QAPI, survey preparation, or ADR/audit response
• Comfort with EMR systems…