Director of Nursing- TRMCC

Work Unit Overview The Director of Nursing is responsible for leading the nursing team to ensure high standards of quality and delivering excellent care to our residents while abiding by the standards of care and excellence required by state and federal laws.

Job Summary The Director of Nursing is an exempt position and assumes full-time administrative authority, responsibility and accountability for the delivery of nursing services in the facility. Manages employees in the provision of care and services according to professional standards of nursing practices, consistent with facility philosophy of care and state and federal laws and regulations. Develops and implements policies and procedures consistent with current law. In collaboration with Nursing Home Administrator, allocates department resources in an efficient and economic manner to enable each resident to attain or maintain the highest practicable, mental and psychosocial well-being. Collaborates with other departments, professionals, consultants, and organizations, including government agencies and advocacy groups, to develop support and coordination of resident care, related administrative functions and to represent the interests of the facility.

Major Duties or Responsibilities These duties are the essential functions and are not all-inclusive of all duties that the incumbent performs.

Able to provide nursing leadership to Nursing Home Administrator, Medical Director, Department Heads and Governing Body to formulate operational strategies and achieve facility objectives within planned budgets and schedules Provides direction to nursing staff to execute tasks necessary to implement operational objectives.

Working knowledge and ability to apply standards of professional nursing practice in job situations.

Able to develop nursing policies and procedures that reflect current clinical practice, professional standards and facility philosophy of care. Able to establish criteria to assure that services provided meet established standards of quality.

Sufficient knowledge of clinical practice, regulations and principles of adult education to supervise t e continuing education and training of nursing personal.

Demonstrates knowledge of and respect for the rights, dignity and individuality of each resident in all interactions. Demonstrated competency in the protection and promotion of resident rights. Able to act as role model for facility staff.

Demonstrates satisfactory level of inter personal skill to interact with facility administration, community and governing agencies, interdisciplinary staff.

Able to understand and to follow written and/or verbal directions. Able to express self adequately in oral/or written communication. Able to communicate effectively with staff members, other professional staff, consultants and residents in interdisciplinary care setting and to government agencies.

Current knowledge of state and federal laws and regulations that apply to practice of nursing in long-term care.

Sufficient knowledge of personnel policies and ability to perform personnel functions including interviewing prospective staff members, conducting performance evaluations and carrying out disciplinary actions when appropriate. Able to apply personnel policies to facts concerning job actions without regard to race, sex, age, national origin, religion or disability.

Carries out all duties in accord with the facility mission and philosophy.

Appreciates the importance of maintaining confidentiality of resident and facility information

Demonstrates honesty and integrity at all times in the care and use of resident and facility property.

Knowledge of emergency and disaster procedures of the facility. Able to locate nearest exit. To understand and respond to written or oral instruction in case of emergency.

Sufficient mobility and strength to move freely through the building, to assure resident safety at all times and to assist, transfer or otherwise move residents of facility out of danger in case of emergency.

Demonstrates respect for co-workers and responds to needs of residents by complying with facility policies on attendance and punctuality and dress code. Able to arrive and to begin work on time and to respond to facility needs 24 hours a day, 7 days a week through on-call availability or delegation.

Working knowledge and ability to comply with facility policies and procedures for workplace safety including infection control procedures, application of universal precautions for blood borne pathogens, use of personal protective equipment and handling of hazardous materials.

Demonstrates ability to prioritize responsibilities and complete projects within allotted time.

Able to respond to change productively and to handle additional projects as delegated. Able to perform essential functions of the Charge Nurse position when needed.

Able to carry out the essential functions of this job (with or without reasonable accommodation) without posing specific, current risk of substantial harm to health and safety of self and others. Develops and maintains nursing policies and procedures that reflect current standards of nursing practice and facility philosophy of care consistent with state and federal laws and regulations.

Communicates and interprets policies and procedures to nursing staff. Monitors practice for effective implementation.

Reviews 24 hour report daily to ensure timely, effective responses to significant changes in condition, transfers, discharges, use of physical or chemical restraints, unexplained injuries, potential abuse or neglect, medication errors, loss of resident property, any evidence of resident or family dissatisfaction. Gathers and analyzes facts, assesses situations, develops and implements appropriate actions to investigate, to notify appropriate parties, to resolve issues and to record facts properly. Keeps Nursing Home Administrator informed of findings and results.

Communicates directly with residents, families, medical staff, nursing staff, interdisciplinary team members and Department Heads to coordinate care and services, improves organization and implementation of plans of care, to maintain quality of life and a homelike environment for all residents.

Establishes and implements infection control program designed to provide a safe, sanitary and comfortable environment and to prevent the development and transmission of disease and infection. Reviews infection control surveillance reports to identify trends and to develop effective actions to control and prevent infections in the facility. Includes infection control information and statistics in Quality Assessment and assurance Committee report.

Monitors the provision of care and services to residents on all shifts and evaluates regulatory compliance efforts through daily rounds to observe care on units, to review records and to interview staff members, residents, families and other interested parties. Evaluates the findings of compliance rounds conducted by designated facility staff on a daily basis. Designs, implements and evaluates actions to continuously improve quality.

Able to coordinate Quality Assessment and Assurance activities with Medical Director, Nursing Home Administrator, Department Heads and direct care staff. Conducts quality assessments and assurance activities, including regulatory compliance rounds, in all departments to monitor performance and to continuously improve quality. Develops programs to gather analyze data for trends and to institute actions to resolve problems promptly.

Evaluates effectiveness of actions. Participates as member of Quality Assurance and Assessment Committee with the Medical Director and at least three other facility staff members. Reports and makes recommendations to Quality Assessment and Assurance committee.

Supervises development of in-service education programs designed to equip nursing staff with sufficient knowledge and skills to provide nursing and nursing related services to each resident to attain or maintain the highest practicable physical, mental and psychosocial well-being and to perform the essential functions of their jobs satisfactorily.

Assists Nursing Home Administrator with preparation for long-term care survey. Actively participates in long term care survey process by instructing staff in matters of conduct and disclosure, maintaining a presence at all times surveyors are on site and directing the timely collection of information required by the team. Demonstrates concern for identified problems and undertakes corrective action while survey is in progress if appropriate. Gathers and presents supplemental documentation to avoid potential deficiencies. Collaborates with Nursing Home Administrator to develop responses to survey report as needed.

Collaborates with physicians, consultants, community agencies and institutions to improve quality of services and to resolve identified problems.

Consults with Nursing Home Administrator daily about resident status, census, budget, personnel and other relevant issues.

Participates in the development of the department budget. Provides relevant financial information to Nursing Home Administrator regarding department financial needs and status.

Develops staffing plans that assure sufficient numbers of qualified, competent nursing staff to meet direct needs, conduct assessments as required, develop plans of care, evaluate residents' responses to interventions and document clinical records effectively in compliance with state and federal requirements. Recommends numbers and types of nursing personnel necessary to provide care and to maintain compliance with facility mission and with regulations.

Hires and retains qualified competent nursing staff to provide nursing and nursing related services to attain or maintain highest practicable physical, mental and psychosocial well-being of each resident. Conducts interviews, provides regular performance reviews, takes appropriate job actions, reviews job actions taken by subordinates to assure that staff meet qualification and performance standards and can perform all essential functions of the job.

Ensures 24-hour availability as nursing administration resource by providing on-call and telephone access or designating an alternative, qualified nursing staff member to do so.

Performs other duties as assigned or directed.

Education Graduate of an accredited school of nursing.

Licenses Current, active license as a Registered Nurse in Montana or the ability to obtain a license as required by the State of Montana to practice.

Work Experience Two years professional nursing experience in long-term care setting. One-year experience in nursing services administration or comparable management experience preferred.

Background and Conduct Requirements Freedom from illegal use of drugs, and freedom from the use and effects of use of drugs and alcohol in the workplace.

Persons who have been found guilty by a court of law of abusing, neglecting or mistreating individuals in a health care related setting are ineligible for employment in this position.

Must pass a background check.

Continuing Education Maintains current skills and knowledge through continuing education. Applies information to job responsibilities.

Professional Knowledge Knowledge of medical office practices, procedures and techniques. Thorough understanding of charting practices and electronic health records. Considerable knowledge of medical terminology, and CLIA and OSHA regulations. Working knowledge of the principles and practices of HIPAA compliance. Working knowledge of procedure and diagnosis coding in primary care settings. Working knowledge of generic and trade name pharmaceuticals. Working knowledge of patient centered medical home delivery system. Working knowledge of the practices and techniques of providing supervision and training. Basic knowledge of Missoula County Human Resource Policies and the provisions of relevant collective bargaining agreements. Working knowledge of the PHC Corporate Compliance Guidelines.

Job Challenges This job cannot be performed without exposure to the stresses associated with an intimate, 24-hour residential care environment that delivers care and services primarily to disabled and cognitively impaired residents. Examples of these stresses include, but are not limited to: shift rotation, weekend and holiday duty, unusual or impaired behavior by residents, family reactions to having a loved one in the nursing home, death and dying, oversight of state surveyors, ombudsmen and federal officials, presence of consultants and attorneys, and variable involvement of medical staff.

Technical Skills Skill in the use of medical management computer programs and standard computer applications, (Word, Excel).

Interpersonal Skills Requires the ability to exercise effective interpersonal communication, and to remain calm and tactful in stressful situations.

Ability to conduct effective interviews.

Ability to train and supervise employees and to facilitate a teamwork environment. Ability to provide patients with access to support services; ability to respect and maintain confidentiality; ability to be culturally sensitive to the needs of the indigent; ability to communicate effectively in the English language, orally and in writing. Ability to establish and maintain effective working relationships with individuals from diverse backgrounds.

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