Director of Nursing

Job Summary

Big Bend Woods Healthcare Center is seeking a dedicated and experienced Director of Nursing to lead our skilled nursing facility. The Director of Nursing is responsible for the overall clinical leadership, administration, and management of nursing services, ensuring the delivery of safe, effective, and resident-centered care.

Essential Responsibilities

• Direct and oversee all nursing services, including assessment, planning, implementation, and evaluation of resident care

• Ensure residents receive individualized care consistent with physician orders, care plans, professional standards, and resident preferences

• Monitor resident conditions and ensure timely assessment, intervention, provider notification, and documentation

• Oversee admissions, transfers, discharges, change-of-condition management, and coordination of care

• Promote resident rights, dignity, privacy, choice, and quality of life

• Review clinical documentation, medication administration practices, treatment records, and nursing notes for completeness and accuracy

• Collaborate with providers, pharmacy services, rehabilitation professionals, social services, dietary services, and other members of the interdisciplinary team

Nursing Department Management

• Recruit, hire, orient, supervise, evaluate, and retain nursing staff, including registered nurses, licensed practical nurses, and certified nursing assistants

• Develop staffing schedules and assignments to support resident acuity, census, continuity of care, and applicable staffing requirements

• Monitor attendance, performance, competency, and compliance with facility policies

• Provide clinical guidance, coaching, counseling, and corrective action when necessary

• Maintain adequate nursing coverage and establish plans for call-offs, emergencies, and unexpected staffing shortages

• Ensure nursing personnel maintain required licenses, certifications, training, and competencies

Regulatory Compliance and Survey Readiness

• Ensure nursing operations comply with applicable Missouri Department of Health and Senior Services (DHSS) requirements, federal Centers for Medicare & Medicaid Services (CMS) regulations, and other applicable laws and standards

• Maintain ongoing readiness for state surveys, federal surveys, complaint investigations, and other regulatory reviews

• Participate in survey preparation, exit conferences, plan-of-correction development, and implementation of corrective actions

• Monitor nursing practices and documentation to identify and correct potential deficiencies

• Ensure timely reporting and investigation of incidents, allegations of abuse, neglect, exploitation, and other reportable events as required by law

Quality Assurance and Performance Improvement

• Participate in and lead nursing-related Quality Assurance and Performance Improvement (QAPI) activities

• Analyze clinical indicators, incidents, adverse outcomes, rehospitalizations, falls, pressure injuries, weight loss, medication errors, and infection trends

• Develop, implement, and evaluate action plans to improve resident outcomes and reduce preventable risks

• Conduct clinical audits and monitor compliance with corrective action plans

• Collaborate with facility leadership to promote accountability, quality improvement, and evidence-based practices

Infection Prevention and Control

• Oversee the facility's nursing-related infection prevention and control practices in collaboration with the designated Infection Preventionist

• Ensure compliance with hand hygiene, personal protective equipment, isolation precautions, cleaning protocols, and applicable infection reporting requirements

• Monitor infections, outbreaks, antibiotic use, and infection-control trends

• Coordinate staff education and implementation of appropriate infection prevention interventions

Medication and Treatment Management

• Oversee safe medication administration and compliance with medication-related policies and applicable regulations

• Coordinate with providers and pharmacy personnel regarding medication reviews, medication changes, and medication-related concerns

• Monitor controlled-substance practices, medication storage, treatment administration, and documentation

• Investigate medication errors and implement appropriate education and prevention measures

Staff Education and Competency

• Develop and coordinate nursing orientation, mandatory education, annual competencies, and ongoing professional development

• Ensure staff receive required training in resident rights, abuse prevention and reporting, infection control, emergency procedures, dementia care, and other applicable topics

• Provide clinical education and mentoring to nursing personnel

• Identify performance gaps and implement targeted education and competency assessments

Risk Management and Incident Response

• Investigate falls, injuries, medication errors, skin concerns, resident complaints, and other clinical incidents

• Ensure timely documentation, appropriate notifications, and required reporting

• Identify contributing factors and implement measures to prevent recurrence

• Communicate significant clinical concerns to the Administrator, Medical Director, attending providers, and other appropriate parties

Physical and Work Requirements

• Ability to work in a skilled nursing facility environment and respond to resident-care and operational needs

• Ability to communicate effectively with residents, families, staff, providers, and regulatory representatives

• Ability to move throughout the facility and perform duties consistent with the essential functions of the position, with reasonable accommodation as applicable

• Availability for occasional evenings, weekends, holidays, and on-call responsibilities as required

Performance Expectations

• Quality and safety of resident care

• Compliance with applicable federal and Missouri regulations

• Nursing documentation accuracy and completeness

• Staffing effectiveness, staff competency, and employee retention

• Infection prevention and control outcomes

• Reduction of preventable adverse events and repeat incidents

• Survey performance and timely completion of corrective actions

• Resident and family satisfaction

• Achievement of established nursing department goals and QAPI initiatives

Equal Employment Opportunity

The facility is an equal opportunity employer and makes employment decisions in accordance with applicable federal and Missouri law.

Missouri Regulatory Note

For a Missouri skilled nursing facility, the job description should specifically reflect these requirements:

• Registered Nurse: Missouri regulations require the Director of Nursing in a skilled nursing facility to be an RN.

• Full-time position: Missouri regulations require a full-time DON responsible for quality of resident care and supervision of personnel providing care.

• Staffing and clinical oversight: The facility must maintain appropriately qualified nursing personnel in sufficient numbers to meet residents' needs.

• Regulatory compliance: The DON's duties should address applicable Missouri DHSS and federal CMS requirements.