Job Description

Primary Purpose

Manage the operations and staff of the Nursing Home and the Adult Residential Care Home, as applicable. Oversee the plan of care and plan of treatment for each individual resident. Participate in the development and training of the nursing staff, in order to implement and deliver necessary care and services to the residents. 

Essential Duties/Functions

• Is accountable and responsible for the care of the residents and staffing 24 hours/day, 7-days/week. 
• In conjunction with DON/ADON, develops, maintains, and implements nursing policies and procedures that conform to current standards of nursing practice, facility philosophy, and operational policies while maintaining compliance with state and federal laws and regulations. 
• Communicates and interprets policies and procedures to nursing staff, and monitors staff practices and implementation. 
• Participates in daily or weekly stand-up, utilization, and management team meetings to discuss resident status, census changes, personnel, or resident complaints or concerns; (Responsible for understanding, managing, and updating IDT on the medical conditions, treatments, nursing skills, and medical discharge planning (for SNF residents) in stand-up and weekly Utilization Review (UR) Meetings. Especially with PDPM being more focused on the medical treatments of residents.
• Ensures delivery of compassionate quality care and nursing supervision as evidenced by adequate services and staff coverage on unit, absence of odors, general cleanliness.
• Follow infection control practices and prevention of pressure wounds (instead of just listing pressure injuries, use outcomes of “quality measures.” This would include pressure injuries/skin issues, and also falls, safety issues, pain control, comfort, maintaining physical function, etc.). 
• Ensure that resident assessments and care plans are timely, accurate and complete. 
• Reviews 24-hour report from every unit daily to monitor and ensure timely, effective responses to significant changes in condition, transfers, discharges, use of restraints, unexplained injuries, falls, behavioral episodes, and medication errors. 
• Coordinates nursing services with all other departments including Therapy. 
• Oversees nursing schedules to assure they meet resident needs and regulatory and budgetary standards. 
• Performs rounds to observe care and to interview staff, residents, families or other interested parties.
• Conducts post-incident investigations and concluding summaries, including finalizing root cause(s), develop of resident specific/effective intervention(s), implementation of intervention(s), ensuring care plan and CNA POC task(s) are updated, and determination of ability to rule out abuse and neglect.

Quality: 

• Demonstrates knowledge of and application of key Quality Measures and proactively implements systems to achieve and/or surpass state and federal thresholds. 
• Is an active member of the QA Committee. Coordinates and/or develops on-going QA activities for nursing services to monitor nursing compliance with standards and regulatory requirements through rounds, interviews, and record reviews. Compiles summary of findings for the Quality Assurance committee. 

Wound and Skin: 

• Ensures that the weekly skin assessments are completed and required nursing action is implemented and care planned. 
• Perform weekly wound and skin rounds with the nursing staff to ensure that wounds have the proper treatment and all interventions to promote wound healing are in place. 

Human Resource: 

• Participates in the recruitment and selection of nursing personnel and assures sufficient staff are hired. 
• Evaluates the work performance of assigned nursing personnel and implements education, training, coaching and discipline according to organization policies. 
• Meets with new employees weekly to follow up on proficiencies and required competencies. 
• Promotes teamwork, mutual respect, and effective communication with nursing staff. 
• Monitors staff for compliance with OSHA mandates and facility policies on workplace safety. 
• Promotes compliance with accident prevention procedures, safety rules, and safe work practices to prevent employee injury and illness and control worker’s compensation costs. 

State and Federal Regulations: 

• Ensures that staff are prepared for inspection surveys, instructing staff on matters of conduct and disclosure, being interviewed by inspectors, immediate corrections of problems noted by surveyors, etc. 
• Reviews and reinforces important standards previously cited. Participates in the preparation of the Plan of Correction response to an inspection survey, and implements any follow-up QA required for any nursing allegations. 
• Investigates facility incidents and complaints daily to identify those defined as unusual occurrences by State policy and promptly reports such occurrences to Director of Nursing/Administrator. 

Customer Relations: 

• Communicates directly with residents, families, medical staff, nursing staff, and interdisciplinary team members, to coordinate care and services, promote participation in care plans, and maintain a high quality of care and life for residents. 
• Promotes customer service and hospitality and responds to and adequately resolves complaints or concerns from residents or families about nursing services. 
• Interacts courteously with residents, family members, employees, visitors, vendors, business associates, and representatives of government agencies. 

Other Responsibilities:

• Works on the nursing unit in the event of a staffing shortage. 
• Knowledgeable of all practices and policies concerning confidentiality of information. 
•  Is a member of the management team with responsibility for general oversight of the organization for: 
• • efficient use of resources, 
  • staff fulfillment of their duties and responsibilities, 
  • staff follow proper work safety standards, 
  • regulatory compliance, 
  • quality resident care. 
• Maintains current physical examination and TB clearance per regulation. 
• Attends any mandatory training and In-Services. 
• Performs other duties as assigned. 

Absence of Director of Nursing: 

• Acts in an administrative capacity in the absence of the DON/ADON. 

Working Conditions

Work Area: Well-lighted, well ventilated work unit. 

Equipment: Ability to use standard equipment such as, but not limited too: residents’ charts, hospital beds, scales, Arjo-Century lifts, infectious waste receptacles, 12 lead EKG, CPAP machines, oxygen tanks and concentrators, etc. 

Work Hours: This is an Exempt position. Work schedule is generally Monday – Fridays, 8am – 4:30pm. May be asked to work other than above shifts as resident care and staff training requires. Will take call on a rotational base 

Mental Demands: Provide professional level of services and a sincere desire to work with the aged and those with limited capacity for self-care. Subject to frequent interruptions. Exposure to infections, odors, and peculiarities in the behavior of aged residents. 

Physical Demands: Requires frequent walking, standing, and sitting during the workday. Requires pushing and pulling of equipment related to resident care, such as: beds, wheelchairs, and recliners in excess of approximately 200 pounds with assistance. Requires lifting, carrying, repositioning and transferring residents who may weigh in excess of 200 ponds with an Arjo-Centry lift. 

Communication Demands: Requires effective verbal communication with all levels of staff, residents, family members, and visitors. Requires effective written communication and proper documentation related to resident care. 

Qualification Requirements 

Skills/knowledge: 

• Excellent verbal and written communication and interpersonal skills required. 
• Previous experience in medical setting and familiarity with long term care and social services procedures. 
• Possess leadership and management skills, techniques, and abilities. Possess a positive attitude. 
• Proficient with Microsoft Office product suite, and experienced with electronic medical records. 
• Demonstrate autonomy, organization, assertiveness, flexibility, and cooperation in performing job responsibilities. 
• Must be able to read and write English to facilitate proper communication with others. 

Education, Licenses and Training: Must have a Bachelor’s Degree in Nursing from an accredited College or University and must have a Hawaii State RN license, First Aid and CPR certification. 

Experience: Required, 2 years of experience as a licensed nurse in a Long-Term Care/Post-Acute Rehab setting. Previous supervisory/management experience preferred. Strong knowledge base and understanding of Long-Term Care concepts, philosophies of care, industry standards, and industry regulations is strongly preferred.