Director of Nursing

Director Of Nursing

The Director of Nursing (DON) provides strategic and operational leadership for nursing services and is accountable for resident-centered clinical care, regulatory compliance, workforce performance, and continuous improvement. In partnership with the Executive Director and interdisciplinary leadership team, the DON ensures nursing resources, competencies, systems, and practices support each resident in attaining or maintaining the highest practicable physical, mental, and psychosocial well-being.

Essential Job Functions

• Direct nursing practice and care-delivery systems to ensure assessments, care plans, clinical interventions, medication management, documentation, and changes in condition are timely, accurate, individualized, and consistent with professional standards.
• Monitor resident outcomes and high-risk clinical indicators—including falls, pressure injuries, infections, weight change, hospital transfers, behavioral health needs, medication events, and other adverse events—and implement effective corrective action.
• Conduct clinical rounds and collaborate with residents, families, physicians, pharmacy, therapy, social services, and other partners to coordinate care, resolve concerns, and promote dignity, choice, safety, and quality of life.
• Maintain nursing services in compliance with applicable federal and state requirements, professional standards, licensure rules, organizational policies, resident rights, and reporting obligations.
• Oversee timely identification, escalation, investigation, documentation, and reporting of incidents, allegations of abuse or neglect, misappropriation, injuries of unknown origin, complaints, and other reportable events in collaboration with the Executive Director and Human Resources, as applicable.
• Maintain continuous survey readiness; lead nursing preparation and response during inspections; support plans of correction; and verify that corrective actions are implemented, monitored, and sustained by nursing team members.
• Build and retain a competent nursing team through workforce planning, interviewing and selection, onboarding, orientation, competency validation, education, coaching, performance management, recognition, and succession planning in partnership with Human Resources.
• Develop and monitor staffing plans and schedules based on resident acuity, census, the community assessment, required competencies, regulatory expectations, and budgeted resources; respond promptly to coverage gaps and emerging clinical needs.
• Set clear expectations, provide consistent accountability, and cultivate psychological safety, teamwork, respectful communication, and professional practice across all shifts and levels of nursing.
• Provide nursing leadership for the community's QAPI program by using data, audits, root-cause analysis, performance improvement projects, and follow-up monitoring to improve care outcomes and prevent recurrence of adverse events.
• Partner with the Infection Preventionist, medical leadership, pharmacy, and interdisciplinary team to maintain an effective infection prevention and control program, surveillance system, outbreak response, and antibiotic stewardship practices.
• Establish nursing metrics and goals; review trends and variances; communicate results to appropriate committees and leaders; and translate findings into measurable, sustainable improvements.
• Develop and manage nursing operating and capital budgets; monitor labor, agency utilization, overtime, supplies, ancillary charges, and clinical resources; and take action to balance quality, staffing, stability, and financial stewardship.
• Evaluate perspective admissions and changes in resident needs in collaboration with the interdisciplinary team to confirm the community can safely and competently meet identified care requirements.
• Maintain effective nursing policies, procedures, records, equipment, supply systems, emergency preparedness practices, and contracted clinical services; participate in drills and respond to requirements.
• Serve as a visible member of the community leadership team, contribute clinical expertise to organizational decisions, communicate priorities clearly, and follow through on commitments and outcomes.
• Maintain responsive, transparent relationships with residents, families, employees, medical providers, vendors, regulators, and community partners; address concerns promptly and escalate significant risks appropriately.
• Perform other duties reasonably related to the position and support community operations during urgent or unusual circumstances, consistent with licensure, competency, and organizational policy.

Value and Leadership Expectations

• Grace – Leads with humility, patience, and accountability; listens before responding; and treats mistakes, conflicts, and difficult decisions as opportunities for learning and improvement.
• Compassion – Keeps resident well-being at the center of decisions, recognizes the needs of employees and families, and responds with empathy, urgency, and appropriate support.
• Respect – Protects dignity, confidentiality, and resident rights; values diverse perspectives; communicates directly and professionally; and creates an environment where people feel safe to speak up.
• Leadership – Models ethical judgment, ownership, collaboration, consistency, and evidence-based decision-making; develops others; address performance and risk promptly; and aligns the nursing team with organizational goals.

Job Qualifications

1. Current, unencumbered Registered Nurse license in the state of practice; graduate of an accredited nursing program, required.
2. At least three (3) years of professional nursing experience, including progressive nursing leadership or management experience; long-term care or senior living experience strongly preferred.
3. Current CPR certification
4. Demonstrated knowledge of gerontological nursing, resident assessment and care planning, infection prevention, QAPI, survey processes, staffing and competency systems, and applicable long-term care regulations.
5. Proficiency with electronic health records, clinical data, scheduling and workforce tools, Microsoft Office, and written and verbal communication.

Knowledge, Skills, and Abilities

1. Ability to analyze clinical and operational data, identify risk, establish facts, make sound decisions, and evaluate whether correction actions are effective.
2. Strong leadership, organization, delegation, conflict-resolution, teaching, time-management, and change-management skills.
3. Ability to interpret laws, regulations, survey guidance, professional standards, policies, financial reports, and clinical records and translate them into reliable daily practice.
4. Ability to communicate effectively with residents and families, frontline staff, physicians, regulators, and executive leaders, including during high-stress or sensitive situations.

Work Schedule and Availability

This leadership role requires flexibility to support a 24-hour operation, including occasional evenings, nights, weekends, holidays, and work beyond the regular schedule. The DON participates in an on-call rotation or consultation coverage as assigned and must be able to respond to the community during urgent or emergency situations within expectations established by the organization.

Physical Requirements

The physical requirements described below represent those typically required to perform the essential functions of this position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential functions, unless doing so would create undue hardship or direct threat under applicable law.

• Frequently communicates, observes, reads, writes, uses a computer and clinical systems, and moves throughout the community; regularly alternates among sitting, standing, and walking.
• Occasionally bends, stoops, reaches, climbs stairs, pushes or pulls equipment, and lifts or carries up to 25 pounds; may assist in an emergency within training and safe-lifting practices.
• Works in office and resident-care settings with interruptions, noise, odors, and potential exposure to infectious agents, bodily fluids, chemicals, and other healthcare hazards; required personal protective equipment and infection-control practices must be used.
• Occasional local or organizational travel may be required.

Expectations of All Employees

1. Support the organization's mission, vision, policies, and commitment to resident-centered service.
2. Maintain confidentiality and comply with HIPAA and other privacy requirements applicable to the position.
3. Complete required education, meetings, and professional development activities.
4. Follow infection prevention, safety, emergency preparedness, and other applicable policies and procedures.
5. Demonstrate professional conduct, reliable communication, collaboration, and respect in interactions with residents, families, employees, visitors, and partners.
6. Perform other duties as assigned consistent with the position's scope and organizational needs.

Note

This job description summarizes the primary duties and expectations of the position. It is not intended to be an exhaustive list of every responsibility, skill, effort, or working conditions associated with the role. Duties may be assigned, modified, or removed based on resident needs, operational requirements, and applicable law. Nothing in this job description alters the at-will employment relationship or creates a contract of employment. I acknowledge that I have reviewed this job description and understand that I am responsible for performing the essential functions of the position, with or without reasonable accommodation, and for complying with organizational policies, professional standards, and applicable laws and regulations.