LPN/RN - Residential Support (Ron Barnes)

GENERAL DESCRIPTION OF DUTIES AND RESPONSIBILITIES:

The LPN/RN - Residential Support is a licensed nursing professional responsible for overseeing medication administration, providing direct medical care, and delivering psycho-educational and supportive therapeutic interventions to meet the mental health, developmental disability, and/or substance abuse needs of clients in a residential setting. This role combines nursing expertise with direct care responsibilities similar to those of residential support staff, ensuring clients aged 18 and older with MH/SA disabilities receive individualized, recovery-focused care that promotes wellness self-management, personal recovery, natural supports, coping skills, self-advocacy, and independent living skills for housing, employment, and full community inclusion. The LPN/RN provides 24/7 access to supports for behavioral health and physical needs, works closely with the interdisciplinary team (including clinical and medical staff), monitors skill acquisition, ensures daily living activities are completed, and advocates for clients’ preferences in treatment and rehabilitation. This position involves supervising medication processes, coordinating with pharmacies and physicians, and participating in crisis interventions, while adhering to all relevant regulations. Supervision is provided by a Qualified Professional or Associate Professional within the identified disability area, with a required annual supervision plan.

MAJOR RESPONSIBILITIES:

• Oversee and administer medications to residents, ensuring accurate dosing, documentation in Medication Administration Records (MARs), and compliance with physician orders and state regulations.
• Coordinate with pharmacies to ensure timely delivery of prescriptions and MARs, and resolve any discrepancies or refill needs.
• Take, record, and report vital signs (e.g., blood pressure, temperature, pulse) as ordered by medical staff, and monitor for changes in health status.
• Work directly with clients (individually or in groups) in residential facilities on functional problems, focusing on preventing, overcoming, or managing deficits in vocational, educational, personal care, domestic, psychosocial, communication, problem-solving, and adaptive skills.
• Provide preventive, developmental, and therapeutic interventions, including psychoeducation strategies and recovery interventions to support individuals with SUD.
• Assist with skill-building interventions, following the Person-Centered Plan (PCP)/service plan and clinical orders.
• Comply with NCAC 27G.5600E requirements for care in a supervised living facility.
• Participate in client intake processes, including collecting basic information (name, DOB, SSN, address), reviewing insurance details, and supporting insurance verification via NCTracks to determine status (No Insurance, Standard Medicaid Plan, or Other Managed Care Plan).
• If no insurance is identified, assist in initiating the Medicaid application process, including gathering documentation (ID, proof of income, residency) and attaching organizational letterhead.
• For clients with Standard Medicaid, support transfer requests to managed care plans (e.g., Trillium Health Resources or Alliance) and begin Substance Abuse (SA) Funds applications, attaching clinical justification and intake notes.
• Assist with shopping, meal preparation, housekeeping, and maintenance of the residence.
• Observe, document, and report client behaviors, medication adherence, and any adverse reactions or health concerns.
• Transport residents to appointments, outings, shopping, etc., as necessary.
• Assist with crisis interventions, using nonviolent crisis intervention techniques.
• Coordinate with the client’s primary physician or medical staff for health needs, repairs, or emergencies.
• Communicate observations and recommendations effectively in written and verbal form to the interdisciplinary team.
• Work independently and as a team member, learning and applying recovery-oriented practices and person-centered approaches.
• Participate in team meetings, provide input into the service planning process or PCP, and follow up on documentation within 24 hours of admission or events.
• Maintain client confidentiality in adherence to HIPAA regulations.
• Complete accurate clinical documentation of all services, interventions, and client-related activities in a timely manner, according to standards.
• Inform clients about benefits, community resources, and services, and assist in obtaining them.
• Consult with other treatment staff and ensure predetermined activities take place.
• Work varied shifts as necessary to ensure 24/7 coverage.

SPECIFIC DUTIES AND RESPONSIBILITIES:

• Ensure the facility functions smoothly during assigned shifts, with a focus on medical oversight and direct care.
• Administer and monitor medications, including education on proper use and side effects.
• Conduct health assessments and respond to medical emergencies in coordination with protocols.
• Support intake and insurance verification workflows, including logging into NCTracks for status checks and initiating applications or transfers as needed.
• Document all nursing interventions, vital signs, and medication administrations in electronic health records.
• Train and guide residential support staff on basic health monitoring and medication observation.
• Maintain the confidentiality of the organization and clients served.
• KNOWLEDGE/SKILLS:
• Strong nursing skills in medication administration, vital signs monitoring, and health assessment.
• Knowledge of psycho-educational strategies, recovery interventions, and substance abuse recovery processes.
• Expertise in daily and community integration, family/caregiver training, and adaptive skill training across functional domains.
• Proficiency in behavior and crisis intervention, symptom management, and wellness evaluation.
• Ability to implement and provide input into Person-Centered Plans.
• Skill in linking clients to diverse resources, including natural, community, and paid supports.
• Understanding of Medicaid workflows, including verification via NCTracks, applications, and managed care transfers.
• Strong relational, supportive, mentoring, and anger management techniques.
• Other duties as assigned.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience:

• Active LPN or RN license in the state of North Carolina.

• Minimum High School Diploma/GED; Associate’s or Bachelor’s degree in Nursing required based on licensure.

• Must qualify as a Paraprofessional, Associate Professional, or Qualified Professional in the relevant disability area.

Certificates, Licenses, Registrations:

• Valid NC Nursing License or Compact License that allows practice in NC;
• Copy of a valid, unrestricted NC Driver’s license, proof of insurance, clean driving record.

Required Skills/Abilities:

• Able to read, write, understand, and follow directions.

• Experience working in a Human Services field, preferably in residential MH/SA settings.

• Clear Healthcare Registry report.

• Available to collaborate with clients at least 5 days per week.

• Document services according to Medicaid and organizational standards, including purpose, interventions, time spent, effectiveness, and signature.

• Ability to read medical records and extract pertinent information quickly.

• Proficient in writing complete service notes.

• Effectively present information and respond to questions from clients and the public.

• Skilled in medication administration and oversight.