Director of Nursing

Director Of Nursing

We are a growing, non-Medicare-certified home health agency primarily serving children and adults with disabilities through skilled and non-skilled home and community-based services. We are seeking an experienced, dependable, and proactive Registered Nurse (RN) Director of Nursing to lead and strengthen our clinical operations as we continue to grow.

Our current census and clinical team structure provides our DON with the opportunity to become genuinely familiar with our clients, their families, field staff, and individual clinical needs while helping us develop the systems and clinical infrastructure needed for continued growth. This is an excellent opportunity for an RN who wants to help strengthen and grow a clinical department rather than simply inherit an established corporate system.

The Director of Nursing (DON) is responsible for the overall clinical leadership, supervision, quality, coordination, and delivery of nursing services provided by the agency.

This is a hands-on working leadership position designed for a growing home health agency with private-duty nursing, skilled nursing, and affiliated community clients.

The DON is expected to independently manage day-to-day clinical operations, maintain familiarity with active patients and their care needs, support field staff, perform assessments and supervisory visits when needed, and ensure clinical issues are identified, followed through, and resolved.

The successful candidate must be proactive, organized, clinically strong, comfortable working both in the office and field, and capable of taking true ownership of the agency's clinical operations.

Administrator

The DON will:

• Assume primary responsibility for day-to-day clinical operations.
• Maintain working knowledge of the agency's active patients, diagnoses, care needs, risks, medications, behavioral considerations, treatment plans, and significant changes in condition.
• Serve as the primary clinical escalation point for field nurses, caregivers, patients, families, case managers, and other members of the care team.
• Independently investigate and resolve routine clinical concerns.
• Determine when matters require escalation to the Administrator, physician, emergency services, payer, or other appropriate entity.
• Monitor changes in patient condition and ensure appropriate follow-up occurs.
• Coordinate continuity of care across nursing staff, providers, case managers, families, pharmacies, DME providers, and other members of the care team.

The DON will:

• Perform or coordinate initial nursing assessments, reassessments, recertifications, resumptions of care, supervisory visits, and discharge assessments as applicable.
• Complete and/or review Plans of Care and ensure they accurately reflect current patient needs and authorized services.
• Review clinical referrals and determine whether the agency can safely and appropriately meet the patient's needs.
• Review available clinical documentation before admission and identify missing information.
• Obtain and follow up on physician/APRN/PA orders and signatures as applicable.
• Track expiring Plans of Care, orders, certifications, and other time-sensitive clinical documentation.
• Ensure ordered visit frequencies and services are consistent with authorizations and the current Plan of Care.
• Coordinate with the authorization/intake team when additional clinical documentation is required to support initial or continued authorization.

For patients receiving services in affiliated community settings, the DON will:

• Maintain detailed familiarity with each patient's clinical condition, medications, treatments, behavioral considerations, risks, appointments, and current care needs.
• Conduct routine clinical rounds and supervisory visits.
• Review MARs/TARs and other clinical records for completeness and accuracy as applicable.
• Follow up on abnormal findings, changes in condition, medication concerns, wounds, falls, hospitalizations, emergency-room visits, and other clinical events.
• Participate in and prepare for MDT meetings and case conferences.
• Communicate effectively with parents/guardians, physicians, case managers, pharmacies, specialists, and other providers.
• Ensure clinical recommendations and action items identified during MDTs or appointments are completed and documented.

The DON will:

• Conduct routine clinical documentation and chart audits reviewing nursing documentation for completeness, accuracy, timeliness, medical necessity, Plan-of-Care compliance, and consistency with authorized services.
• Track recurring documentation errors and provide staff education or corrective coaching.
• Review admission, recertification, resumption-of-care, discharge, supervisory, and other applicable clinical documentation.
• Work with billing and administrative staff to resolve clinical documentation deficiencies that prevent clean claim submission.
• Assist in developing systems that reduce claim delays caused by clinical documentation errors.

The DON will:

• Review and investigate clinical incidents, including medication errors, falls, wounds/skin concerns, injuries, hospitalizations, changes in condition, and other adverse events.
• Ensure physicians, representatives, case managers, regulators, or other parties have been notified when required.
• Conduct or participate in root-cause analysis.
• Develop and monitor corrective actions.
• Identify trends and recurring risks across patients, homes, and staff.
• Escalate significant clinical, regulatory, legal, or patient-safety concerns promptly to the Administrator.

The DON will:

• Provide clinical supervision to RNs, LPNs, CNAs/HHAs and other applicable clinical personnel within the agency's organizational structure.
• Participate in clinical interviews and provide recommendations regarding nursing candidates.
• Conduct or oversee clinical orientation.
• Complete competency validation/check-offs appropriate to the employee's assigned duties.
• Identify nurses who require additional education or remediation.
• Provide focused clinical education and skills refreshers.
• Conduct supervisory and performance visits in the field.
• Partner with HR and the Administrator regarding clinical performance concerns, corrective action, suspension from patient care, or termination recommendations.
• Ensure nurses are assigned only to patients whose needs are consistent with their demonstrated competency and scope of practice.

The DON will:

• Provide timely clinical review of incoming referrals.
• Determine whether the agency has the clinical capability to safely accept a case.
• Identify required nursing skill level and competencies.
• Review clinical documentation for appropriateness and completeness.
• Communicate clinical documentation needs to the Intake/Authorization Coordinator.
• Assist with complex authorization requests, denials, peer-to-peer preparation, letters of medical necessity, or other clinical justification when appropriate.
• Participate in admission planning to ensure staffing, orders, supplies, equipment, and clinical needs are addressed before start of care.

The DON will:

• Work collaboratively with the Staffing/Scheduling Coordinator regarding patient acuity, staff competency, skill matching, authorized hours/visits, and clinical coverage concerns.
• Assist with urgent clinical coverage when necessary to protect patient safety and continuity of care.
• Participate in the clinical on-call rotation as assigned.
• Provide clinical direction during urgent staffing situations.

The DON will:

• Participate in and help lead clinical components of QAPI.
• Track clinical trends, incidents, documentation deficiencies, hospitalizations, complaints, infections, wounds, medication errors, and other identified indicators.
• Develop and monitor clinical performance-improvement initiatives.
• Assist with AHCA, payer, Medicaid MCO, accreditation, and other applicable reviews.
• Maintain clinical operations in a survey-ready state.
• Assist with policy review and implementation as related to nursing and clinical services.

This is a working clinical leadership position.

Depending on census and operational needs, the DON may:

• Perform assessments and supervisory visits.
• Conduct clinical rounds at community residential settings.
• Provide skilled nursing visits when necessary to support continuity of care.
• Conduct staff competency observations in the field.
• Attend patient care conferences when clinically necessary.

Success in this position includes:

• Clinical concerns are followed through as appropriate.
• Plans of Care,