Job DescriptionJob Description:\n\nDescription: The primary purpose of your job position is to plan, organize, develop and direct the overall operation of our Nursing Service Department in accordance with current federal, state, and local standards, guidelines, and regulations that govern our facility, and as may be directed by the Administrator and the Medical Director, to ensure that the highest degree of quality care is maintained at all times. Delegation of Authority As Director of Nursing Services, you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties. In the absence of the Medical Director, you are charged with carrying out the resident care policies established by this facility. Job Functions Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position. Duties and Responsibilities Administrative FunctionsPlan, develop, organize, implement, evaluate, and direct the nursing service department, as well as its programs and activities, in accordance with current rules, regulations, and guidelines that govern the nursing care facilities.Review, maintain, and implement company policies, processes and procedures that govern the day-to-day functions of the nursing service department.Maintain a reference library of written nursing material (i.e., PDR’S, Regulations, Standards of Practice, etc.) that will assist the nursing service department in meeting the day-to-day needs of the resident.Review and make recommendations and annually adopt the clinical policies, procedures and company pathways.Maintain a nursing service organization structure.Make written and oral reports/recommendations to the Administrator, as necessary/required, concerning the operation of the nursing service department.Review, maintain, and periodically update written job descriptions for each level of nursing personnel in accordance with pertinent laws and regulations.Revise and operationalize methods for coordination of nursing services with other resident services to ensure the continuity of the residents’ total regimen of care.Actively participate and sustain an ongoing quality assurance program for the nursing service department.Participate in facility surveys (inspections) made by authorized government agencies as necessary or as may be directed.Assist the Quality Assessment & Assurance Committee in developing and implementing appropriate plans of action to correct identified deficiencies.Assist the Discharge Planning Coordinator in developing, implementing and periodically updating the written procedures for the Discharge Planning Program.Assist the resident and Discharge Planning Coordinator in planning the nursing services portion of the resident’s discharge plan.Perform administrative duties such as completing medical forms, reports, evaluations, studies, charting, etc., as necessary.Monitor the facility’s 5 Star, QRP, MDS and survey reports. Assist in developing of PIP’s, plans of action to correct potential or identified problem areas.Assist in calculating the number of direct nursing care personnel on duty each shift. Report such information to the Administrator or his/her designee to ensure that accurate staffing information is posted.Agree not to disclose assigned user ID code and password for accessing resident/facility information and promptly report suspected or known violations of such disclosure to the Administrator.Agree not to disclose resident’s protected health information and promptly report suspected or known violations of such disclosure to the Administrator.Report any known or suspected unauthorized attempt to access facility’s information system.Reportable: With LNHA, review any home office observations, comments, recommendations, participating in the final product with the LNHA; submit it in a timely fashionAssist with investigations, communications and staff interviews and participate in the development of initial/final reportable for Home Office Review (exception: 2 hr. reporting window during off hours)Participate, conduct, evaluate and complete clinical (and others as assigned) investigationsNotify Home Office timely of unusual events and unique clinical concernsOther duties as assigned. Personnel FunctionsReview the established staffing pattern and ratios. Evaluate the staffing needs of the nursing service department necessary to meet the total nursing needs of the residents. Communicate needs to the Administrator.Work daily with the staffing coordinator/designee to ensure adequate staffing, ratios, and labor management of the nursing departmentRecruit, interview, screen and secure the appropriate number of trained, skilled nursing service personnel.With HR, ensure that all nursing personnel are vetted and licensed.Assign a sufficient number of licensed practical and/or registered nurses for each tour of duty to ensure that quality care is maintained.Assign a sufficient number of certified nursing assistants for each tour of duty to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident.Ensure that all nurse aide trainees are under the direct supervision of a licensed nurse.Develop and facilitate work assignments and schedule duty hours, and/or assist nursing supervisory staff in completing and performing such tasks.Delegate to nursing service supervisory personnel the administrative authority, responsibility, and accountability necessary to perform their assigned duties.Conduct probationary and annual performance evaluation schedules, criteria, and annual reviews for the nursing service department (e.g., RNs, LPNs, CNAs, medication aides, etc.)Make frequent rounds of the nursing service department (all shifts) to ensure that all nursing service personnel are performing their work assignments in accordance with acceptable nursing standards.Monitor missed punches, unauthorized OT, absenteeism and lateness to ensure that an adequate number of nursing care personnel are on duty at all times and staff practices are in accordance with facility policy.Review, revise, maintain, and implement written processes for ensuring that professional nursing personnel, including private duty nurses, have valid and current licenses as required by this State.Promptly review complaints and grievances made or filed by department personnel. Notify Administrator and participate in investigation and reportables as appropriate.Promptly provide complaint/grievance reports to the Administrator as required or as may be necessary.Ensure that departmental disciplinary action is administered fairly and without regard to race, color, creed, national origin, age, sex, religion, handicap, or marital status.Appoint an Infection Preventionist; ensuring adequate training and management of an adequate infection control program.Report occupational exposures to blood, body fluids, infectious materials, and hazardous chemicals in accordance with the facility’s policies and procedures governing accidents and incidents.Conduct or facilitate annual Inservice training and clinical competencies with nursing staff.Terminate employment of personnel when necessary, documenting and coordinating such actions with the Administrator/Home officeReport known or suspected incidents of fraud to the Administrator.Ensure that departmental computer workstations left unattended are properly logged off or the password protected automatic screensaver activates within established facility policy guidelines.Other duties as assigned. Nursing Care FunctionsParticipate in the interviewing and selection of residents for admission to the facility, including PASARR screenings.Provide the Administrator with information relative to the nursing needs of the resident and the nursing service department’s ability to meet those needs.Inform nursing service personnel of new admissions, their expected time of arrival, room assignment, etc.With the Admissions team, ensure that rooms are ready for new admissions.Greet newly admitted residents upon admission. Escort to room as necessary.Make rounds with physicians as necessary. Schedule physician visits as necessary.Monitor and ensure that attending physicians record and sign progress notes, physicians’ orders, etc., on a timely basis and in accordance with current regulations.Ensure that direct nursing care be provided by a licensed nurse, a CNA, and/or a nurse aide trainee qualified to perform the procedure.Review nurses’ notes to ensure that they are informative and descriptive of the nursing care being provided, that they reflect the resident’s response to the care, and that such care is provided in accordance with the resident’s wishes.Schedule daily rounds to observe residents and to determine if nursing needs are being met in accordance with the resident’s request.Monitor medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled.Provide direct nursing care as necessary.Ensure that residents who are unable to call for help are checked frequently.Conduct routine clinical review meetings such as daily clinical stand up/down, weekly at-risk meetings. Maintain minutes and ensure prompt follow up.Review the 24-hour report and clinical dashboards daily; ensuring prompt, accurate follow up.Ensure timely, accurate responses to pharmacy concerns or needs (e.g. PA’s, etc.)Fully evaluate incidents and reportables, notify LNHA, MD, IDT, Home office and others of findings. Care Plan revisions with resident. PIP's as needed.Fully evaluate resident COC's with team, notify LNHA, MD, IDT, Home office and others of findings. Care Plan revisions with resident. PIP's as needed.Fully evaluate PI's, falls, pain, etc., notify LNHA, MD, IDT, Home office and others of findings. Care Plan revisions with resident. Incident Reports completed. PIP's as needed.Fully evaluate unplanned transfers, notify LNHA, MD, IDT, Home office and others of findings. Care Plan revisions with resident. PIP's as needed.Review all new and re admissions; ensuring a completed comprehensive review and compliance with ordersReview residents with significant changes; ensuring a completed assessment, responsive action, notification, and documentation complianceReview Pharmacy portal and pharmacy communiques with a focus on new medications (timely receipt), formulary compliance, cost control measures, prior authorization timeliness, etc.Check MAR's/TAR's; ensuring accurate documentation, diagnosis and responsive action including but not limited to RP/MD notification and care plan revisionsDialysis Residents: Ensure Dialysis-Facility communications are being maintained and care delivered in accordance with standards.Check Narcotic logs; ensuring compliance with count, storage, documentation and Narc. Logs/MAR's reconcileCheck med carts at least weekly; ensuring appropriate storage, cleanliness, absence of expired products, etc.Check treatment carts at least weekly; ensuring appropriate ensuring appropriate storage, cleanliness, absence of expired products, etc.Check med rooms, Stat/emergency boxes and Omnicell/Pixys at least weekly; ensuring appropriate storage, cleanliness, absence of expired products, etc.Other duties as assigned. Safety and SanitationAssist the Safety Officer in developing safety standards for the nursing service department.Ensure that the department’s policy and procedure manuals identify safety precautions and equipment to use when performing tasks that could result in bodily injury.Assist the Infection Preventionist in identifying, evaluating, and classifying routine and job-related functions to ensure that tasks in which potential exposure to blood/body fluids are properly identified and recorded.Ensure that all personnel performing tasks that involve potential exposure to blood/body fluids participate in appropriate in-service training programs prior to performing such tasks.Ensure that adequate supplies of personal protective equipment are on hand and are readily available to personnel who perform procedures that involve exposure to blood or body fluids.Monitor nursing service personnel to ensure that they are following established safety regulations in the use of equipment and supplies.Ensure that nursing service work areas (i.e., nurses’ stations, medicine preparation rooms, etc.) are maintained in a clean and sanitary manner.Ensure that all resident care rooms, treatment areas, etc., are maintained in a clean, safe, and sanitary manner.Ensure that all nursing service personnel follow established departmental policies and procedures, including appropriate dress codes.Ensure that nursing service personnel participate in and conduct all fire safety and disaster preparedness drills in a safe and professional manner.Assist the Infection Control Committee in the development, implementation, and revising of written aseptic and isolation techniques.Implement and maintain a program for monitoring communicable and/or infectious diseases, including TB, among the residents and personnel.Ensure that nursing service personnel follow established infection control procedures when isolation precautions become necessary.Implement, and maintain a procedure for reporting hazardous conditions or equipment.Ensure that personnel wear and/or use safety equipment and supplies (e.g., back brace, mechanical lifts, etc.) when lifting or moving residents.Report missing/illegible labels and MSDSs to the safety officer or other designated person.Other duties as assigned. MDS, MMQ’s (Massachusetts) & Care Plan and Assessment FunctionsAssign, assist and monitor the development of baseline and comprehensive assessments of the nursing needs of each resident.With the resident/representative, develop a person-centered written plan of care (baseline and comprehensive) for each resident that identifies the problems/needs of the resident, indicates the care to be given, goals to be accomplished, and which professional service is responsible for each element of care.Encourage the resident and his/her family to participate in the development and review of the resident’s plan of care.Assist the Resident Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the completion of CAA’s.Work with the Resident Assessment/Care Plan Coordinator to ensure the development of an MDS schedule, timely and accurate completion of MDS’s, accurate coordination of services and scheduling of resident care conferences in accordance with regulations.Ensure that all personnel involved in providing care to the resident are aware of the resident ’s care plan. Ensure that nursing personnel refer to the resident’s care plan
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