Director of Nurses (Registered Nurse)
MINIMUM QUALIFICATIONS EDUCATION/TRAINING/EXPERIENCE 1. Must be currently licensed as an RN through the Board of Nursing in the state of practice. 2. Must have at least an Associate's Degree in Nursing. 3. Must have a minimum of one year nursing experience within the last 36 months. 4. Prefer at least one year experience in home health. Must understand the issues related to the delivery of home health services and be able to problem solve effectively. Must possess knowledge of the Medicare guidelines governing home health agencies or have experience/abilities that indicate with training they would excel. 5. Prefer management experience
CHARACTERISTICS 1. Must be organized, detail oriented and possess effective communication skills, both orally and in writing. The ability to communicate with a diversity of individuals is required. 2. Must understand the issues related to the delivery of home health care and be able to problem-solve effectively. 3. Must be capable of prioritizing and handling multiple tasks of critical importance simultaneously. 4. Must function well in atmosphere of stress and interruption. 5. Must have good clinical judgment and observation skills 6. Must have a positive attitude and be self-directed. 7. Must be willing to comply with accepted professional standards and principles. 8. Must be flexible and cooperative in fulfilling role obligation. 9. Must have satisfactory references from previous (or current) employers, nursing school, and/or professional peers.
MINIMUM REQUIREMENTS 1. Must possess a valid state driver's license and adhere to all state laws while driving. 2. Must possess automobile liability insurance. 3. Must have dependable transportation kept in good working condition. 4. Must be able to drive an automobile in various types of weather/road conditions. 5. Must possess intermediate computer skills.
SUMMARY OF JOB RESPONSIBILITIES The Director of Nurses (DON) is a Registered Nurse supervises the provision of therapeutic services provided from all disciplines and is responsible for overall care and case management activities in their assigned branch office(s). The DON directs all branch operations and ensures that care/services, delivered by staff and contract disciplines, meet the patient's needs and are compliant with Agency Policies, State and Federal Laws and Regulations. The DON is expected to lead their branch office with excellence to excel at quality care, quality documentation, growth, and financial viability.
RESPONSIBILITIES AND DUTIES 1. Supervises staff and the day-to-day office/clinical/field operations. Ensures daily tasks are completed even during staff absences. Monitors daily workload and delegates responsibilities when required. 2. Provides a positive work environment by consistently modeling in a positive way, the agency philosophy, mission, values, and standards of care, and providing a professional role model for other staff. 3. Reads and adheres to all Agency Policies and Procedures. Adheres to all State and Federal laws and regulations. 4. Adheres to HIPAA regulations and follows agency protocol maintaining confidentiality and does not improperly disclose patient information. 5. Makes staffing priority to assure adequate supply of qualified staff. Coordinates with the Recruiting Department to inform them of staffing needs, promptly reviews applications and interviews applicants who meet requirements, and communicates to recruiting the desire to hire qualified applicant. 6. Assesses and ensures initial competency of staff and assigns new clinical employees to qualified preceptor from their office prior to classroom training, and ensures all new employees view e-learning presentations and attend classroom training as directed. 7. Participates in orientating and terminating field and office staff. Ensures HR is notified of employee change of status which includes position change, termination, changes of address, etc. 8. Follows up on HR deficiencies that have not been resolved. 9. Completes appraisal of direct subordinates according to agency policies and procedures, assisting subordinates with professional growth and development. Handles staff complaints and incidents in a timely manner. Counsels staff appropriately and timely concerning areas of deficiency. Consistently facilitates positive interpersonal relations among staff and provides positive feedback for excellent performance. 10. Provides monthly in-services and general staff meetings. Attends meetings and additional educational seminars as required by Administration. 11. Works with the Director of Education in the planning, implementation, and evaluation of in-service and continuing education programs. Provides adequate opportunity for education and assures that all staff meets training and in-service requirements. 12. Is diligent in activities that ensure advanced proficiency in Homecare Homebase (HCHB) Electronic Health Record (EHR). Actively seeks out training and continuing education in agency processes including participation in offered classroom training, e-learning courses, and training materials within the resource center in HCHB. 13. Generates quarterly On-Call Visit Nurse schedule. Ensures patients coming out of the hospital, evaluations, and routine visits to be done after hours or on the weekend are scheduled on staff from their branch office prior to the weekend. 14. Participates in Visit Nurse On-call rotation and assumes on-call duties as assigned. Must be available 24 hours per day when scheduled to be on-call. Must be reachable at all times and comply with the On-Call Process. 15. Monitors reports and ensures staff is completing duties accurately and timely as indicated within their job descriptions to prevent any deficiencies in their branch office. 16. Ensures productivity standards are met by field staff. Reviews and approves bi-weekly payroll transmittal. Runs reports as indicated in the DON workflow under client related tasks and as indicated in the Administrative tasks to monitor duration of visits, number of units, approve on-call activity, etc. 17. Communicates as appropriate with staff, physicians, referral sources, community, patients, potential patients, caregivers, and others involved in care. Ensures excellent customer service is being provided to all patients, physicians and other affiliates. 18. Receives referrals with enthusiasm from physicians and staff. Reviews available patient information related to case, including disciplines required and anticipated home care needs, to determine if patient needs can be met by your staff and/or contract disciplines. Enters referral into the Electronic Health Record (EHR) completing the sections indicated within intake/authorizations, clearly identifying the referral source and identifying team who will be managing patient care. 19. Follows up timely on pending referrals and all non-Medicare referrals through the admissions and billing process. 20. Provides onsite supervision of Clinical Supervisors (CS) to ensure they are completing workflow accurately and promptly. As necessary, assists the CS and clinicians in establishing immediate, short and long-term therapeutic goals, in setting priorities, and in developing plan of care. 21. Ensures Physician Certification (F2F) is received or completes the process of Delayed Physician Certification for Home Health Services if the Certification was not received upon referral. Review/edit/approve F2F Encounter Documentation to ensure Medicare requirements for encounter documentation is met. Follow up on unresolved F2F encounters when workflow is triggered as time lapses. 22. Approves/denies paid time off (PDO) requested by staff notifying Area Clinical Supervisor if position cannot be covered prior to approving PDO. Communicate time-off with the Patient Services Coordinator (PSC) so they can appropriately schedule. Ensures the PSC is scheduling geographically and meeting the needs of the patient, staff, and agency assuring productivity expectations are being met. Ensures PSC is scheduling utilizing buddy codes as appropriate. 23. Assures appropriate documentation is completed for all patients transferred to an inpatient facility. Assures hospital discharge planner is aware patient is on our services and patient receives daily contact from the CS. 24. Assures that the patient's plan of care is executed as written and reassessed by the appropriate health care professional upon Start of Care (SOC)/Recert, when there is a significant health status change (SCIC) in the patient's condition, at the physician's request, and Resumption of Care (ROC) after hospital discharge. 25. Participates in the Recert/DC decision to determine if the patient has skilled need requiring ongoing home health services or if all needs have been met and patient no longer meets criteria to continue services. 26. Enters Transfers, Death at Home, and Discharge at End of Episode (EOE) as necessary and completes workflow as it appears under client related tasks, coordination notes, and administrative tasks. 27. Edits/Locks OASIS once documentation is complete, it has been reviewed by the CS, has been reviewed by the Coding Specialist and updates have been made, and claim codes have been reviewed. 28. Reviews and evaluates patient care by reviewing the services provided by the CS and clinicians. Performs review of clinical records to promote more effective performance and delivery of quality home care services. Assures service satisfaction through patient visits, phone conversations, and other measures as appropriate. Staff receives and enters patient complaints in the EHR which triggers workflow to the DON to investigate and resolve the issue. 29. Completes tasks and workflow accurately and timely as they escalate from the CS due to exceeding time limits or tasks that go to both the DON and CS. 30. Performs chart reviews to ensure patients on services meet criteria established by their payer source such as medical necessity and homebound status and ensure documentation clearly indicates the criteria are met. Ensures assessing clinicians and ancillary staff provides exceptional patient care by utilizing all elements of the nursing process and/or agency standards of care. Ensures the level of care and services provided coincide with the patients' level of acuity and meet their needs. Ensure assessing clinicians and ancillary staff is providing care within their scope of practice and submits quality documentation authenticating appropriate assessment and intervention provided to the patient. 31. Ensures appropriate action is taken on any suspected abuse and/or neglect cases. 32. Functions in the capacity of Clinical Supervisor, Field Nurse, or Aide when necessary. Completes workflow in client related task, coordination notes, and administrative task for staff who are absent or need additional assistance with completing their workflow. 33. Coordinates with the Outcomes Supervisor to ensure proper care and documentation when Potentially Avoidable Events are detected and to ensure we are progressing towards improving outcomes utilizing Process Quality Measures. 34. Ensure employees complete incident reports when incidents occur as directed in agency policy and procedure and document all follow up related to the incident. Reviews QI reports such as Infection Control Logs to control the spread of infection from staff to patients and documents follow up related to infections; Reviews Occurrence Logs and documents follow-up related to the occurrence; and Reviews Medication Error Logs documenting all follow up related to the error. Counseling/termination may be necessary depending on severity of incident. 35. Ensures staff is compliant with the monitoring of blood glucose machines to ensure proper calibration. 36. Completes clinical related tasks such as entering non-admits, voiding orders, etc as necessary. Runs reports to track Missed Visits and Declined Visits and investigates to ensure patient meets homebound criteria and ensure employee is being compliant with making visits as scheduled. 37. Participates enthusiastically in short and long range planning for the branch and implements specific measures for growth. Is always aware of hospitalizations, discharges, census, and recent admissions. 38. Participates in public relations and community activities that promote the agency's role as an effective member of the health care delivery system. Participates during flu season making the community aware of Influenza and preventative measures offering vaccinations to provide protection to the public. Participates in educating physicians and other community and referral sources. 39. Participates on the peer review committee presenting patient case studies for review. 40. Coordinates closely with immediate supervisor to inform them of any issues within your branch office, receive direction on unusual circumstances, notify them of staffing requirements, include in plans for growth and financial viability, report staff who are not meeting performance expectations, discuss reports associated with EHR, etc. 41. Coordinates closely with contract disciplines and therapy companies to ensure their delivery of care meets all agency, state and federal laws and regulations. Ensures the CS understands their responsibilities with care oversight and is collaborating with therapy. Ensures therapist are meeting care, timelines, and documentation expectations and holding them accountable when expectations are not being met. Seeks to contract with different therapy companies or therapists when expectations cannot be met by current contracted companies. Is responsible to ensure quality care is being provided by all staff and contract employees/companies. 42. Responsible for complying with all Agency Policies and Procedures, State and Federal Laws and Regulations.
Disclaimer:
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities and will be directed by their Area Clinical Supervisor as the need arises.
WORKING CONDITIONS 1. General office. 2. Work is moderate with a combination of sitting, standing, and walking. 3. Travel to other branch offices, designated facilities for training/meetings, and/or patient homes. 4. Community and client home environment. 5. Potential exposure to blood and/or body fluids and infectious disease during the performance of job duties. 6. Potential exposure to extreme temperature and humidity when traveling. 7. Potential exposure to dust, gas, fumes, and odors during traveling. 8. This position has been designated as clinical management (see Infection/Exposure Control Plan). Employees performing clinical management duties may be involved in potential exposure to blood borne pathogens and other potentially infectious materials. All clinical management employees will be offered Hepatitis B vaccination at no expense to the employee.
PHYSICAL REQUIREMENTS 1. Visual and manual dexterity is required 2. Good physical stamina and mental health is required. Has completed the agency pre-employment health clearance. 3. Ability to perform tasks involving physical activity, which may include heavy lifting and extensive bending and standing. 4. Ability to deal effectively with stress. 5. Ability to communicate effectively with staff, patients, family, and physicians through speaking and hearing. 6. Ability to operate office equipment including, but not limited to, computers, printers, copiers, etc.
CONTINUING EDUCATION REQUIREMENTS The Director of Nurses (DON) must meet the required continuing education hours for state certification as a nurse in Texas as applicable. Agency personnel are expected to participate in appropriate continuing education as may be requested and/or required by their immediate supervisor. In addition, agency personnel are expected to accept personal responsibility for other educational activities to enhance job related skills and abilities. All agency personnel must attend mandatory educational programs.Estimated Salary: $20 to $28 per hour based on qualifications.
CHARACTERISTICS 1. Must be organized, detail oriented and possess effective communication skills, both orally and in writing. The ability to communicate with a diversity of individuals is required. 2. Must understand the issues related to the delivery of home health care and be able to problem-solve effectively. 3. Must be capable of prioritizing and handling multiple tasks of critical importance simultaneously. 4. Must function well in atmosphere of stress and interruption. 5. Must have good clinical judgment and observation skills 6. Must have a positive attitude and be self-directed. 7. Must be willing to comply with accepted professional standards and principles. 8. Must be flexible and cooperative in fulfilling role obligation. 9. Must have satisfactory references from previous (or current) employers, nursing school, and/or professional peers.
MINIMUM REQUIREMENTS 1. Must possess a valid state driver's license and adhere to all state laws while driving. 2. Must possess automobile liability insurance. 3. Must have dependable transportation kept in good working condition. 4. Must be able to drive an automobile in various types of weather/road conditions. 5. Must possess intermediate computer skills.
SUMMARY OF JOB RESPONSIBILITIES The Director of Nurses (DON) is a Registered Nurse supervises the provision of therapeutic services provided from all disciplines and is responsible for overall care and case management activities in their assigned branch office(s). The DON directs all branch operations and ensures that care/services, delivered by staff and contract disciplines, meet the patient's needs and are compliant with Agency Policies, State and Federal Laws and Regulations. The DON is expected to lead their branch office with excellence to excel at quality care, quality documentation, growth, and financial viability.
RESPONSIBILITIES AND DUTIES 1. Supervises staff and the day-to-day office/clinical/field operations. Ensures daily tasks are completed even during staff absences. Monitors daily workload and delegates responsibilities when required. 2. Provides a positive work environment by consistently modeling in a positive way, the agency philosophy, mission, values, and standards of care, and providing a professional role model for other staff. 3. Reads and adheres to all Agency Policies and Procedures. Adheres to all State and Federal laws and regulations. 4. Adheres to HIPAA regulations and follows agency protocol maintaining confidentiality and does not improperly disclose patient information. 5. Makes staffing priority to assure adequate supply of qualified staff. Coordinates with the Recruiting Department to inform them of staffing needs, promptly reviews applications and interviews applicants who meet requirements, and communicates to recruiting the desire to hire qualified applicant. 6. Assesses and ensures initial competency of staff and assigns new clinical employees to qualified preceptor from their office prior to classroom training, and ensures all new employees view e-learning presentations and attend classroom training as directed. 7. Participates in orientating and terminating field and office staff. Ensures HR is notified of employee change of status which includes position change, termination, changes of address, etc. 8. Follows up on HR deficiencies that have not been resolved. 9. Completes appraisal of direct subordinates according to agency policies and procedures, assisting subordinates with professional growth and development. Handles staff complaints and incidents in a timely manner. Counsels staff appropriately and timely concerning areas of deficiency. Consistently facilitates positive interpersonal relations among staff and provides positive feedback for excellent performance. 10. Provides monthly in-services and general staff meetings. Attends meetings and additional educational seminars as required by Administration. 11. Works with the Director of Education in the planning, implementation, and evaluation of in-service and continuing education programs. Provides adequate opportunity for education and assures that all staff meets training and in-service requirements. 12. Is diligent in activities that ensure advanced proficiency in Homecare Homebase (HCHB) Electronic Health Record (EHR). Actively seeks out training and continuing education in agency processes including participation in offered classroom training, e-learning courses, and training materials within the resource center in HCHB. 13. Generates quarterly On-Call Visit Nurse schedule. Ensures patients coming out of the hospital, evaluations, and routine visits to be done after hours or on the weekend are scheduled on staff from their branch office prior to the weekend. 14. Participates in Visit Nurse On-call rotation and assumes on-call duties as assigned. Must be available 24 hours per day when scheduled to be on-call. Must be reachable at all times and comply with the On-Call Process. 15. Monitors reports and ensures staff is completing duties accurately and timely as indicated within their job descriptions to prevent any deficiencies in their branch office. 16. Ensures productivity standards are met by field staff. Reviews and approves bi-weekly payroll transmittal. Runs reports as indicated in the DON workflow under client related tasks and as indicated in the Administrative tasks to monitor duration of visits, number of units, approve on-call activity, etc. 17. Communicates as appropriate with staff, physicians, referral sources, community, patients, potential patients, caregivers, and others involved in care. Ensures excellent customer service is being provided to all patients, physicians and other affiliates. 18. Receives referrals with enthusiasm from physicians and staff. Reviews available patient information related to case, including disciplines required and anticipated home care needs, to determine if patient needs can be met by your staff and/or contract disciplines. Enters referral into the Electronic Health Record (EHR) completing the sections indicated within intake/authorizations, clearly identifying the referral source and identifying team who will be managing patient care. 19. Follows up timely on pending referrals and all non-Medicare referrals through the admissions and billing process. 20. Provides onsite supervision of Clinical Supervisors (CS) to ensure they are completing workflow accurately and promptly. As necessary, assists the CS and clinicians in establishing immediate, short and long-term therapeutic goals, in setting priorities, and in developing plan of care. 21. Ensures Physician Certification (F2F) is received or completes the process of Delayed Physician Certification for Home Health Services if the Certification was not received upon referral. Review/edit/approve F2F Encounter Documentation to ensure Medicare requirements for encounter documentation is met. Follow up on unresolved F2F encounters when workflow is triggered as time lapses. 22. Approves/denies paid time off (PDO) requested by staff notifying Area Clinical Supervisor if position cannot be covered prior to approving PDO. Communicate time-off with the Patient Services Coordinator (PSC) so they can appropriately schedule. Ensures the PSC is scheduling geographically and meeting the needs of the patient, staff, and agency assuring productivity expectations are being met. Ensures PSC is scheduling utilizing buddy codes as appropriate. 23. Assures appropriate documentation is completed for all patients transferred to an inpatient facility. Assures hospital discharge planner is aware patient is on our services and patient receives daily contact from the CS. 24. Assures that the patient's plan of care is executed as written and reassessed by the appropriate health care professional upon Start of Care (SOC)/Recert, when there is a significant health status change (SCIC) in the patient's condition, at the physician's request, and Resumption of Care (ROC) after hospital discharge. 25. Participates in the Recert/DC decision to determine if the patient has skilled need requiring ongoing home health services or if all needs have been met and patient no longer meets criteria to continue services. 26. Enters Transfers, Death at Home, and Discharge at End of Episode (EOE) as necessary and completes workflow as it appears under client related tasks, coordination notes, and administrative tasks. 27. Edits/Locks OASIS once documentation is complete, it has been reviewed by the CS, has been reviewed by the Coding Specialist and updates have been made, and claim codes have been reviewed. 28. Reviews and evaluates patient care by reviewing the services provided by the CS and clinicians. Performs review of clinical records to promote more effective performance and delivery of quality home care services. Assures service satisfaction through patient visits, phone conversations, and other measures as appropriate. Staff receives and enters patient complaints in the EHR which triggers workflow to the DON to investigate and resolve the issue. 29. Completes tasks and workflow accurately and timely as they escalate from the CS due to exceeding time limits or tasks that go to both the DON and CS. 30. Performs chart reviews to ensure patients on services meet criteria established by their payer source such as medical necessity and homebound status and ensure documentation clearly indicates the criteria are met. Ensures assessing clinicians and ancillary staff provides exceptional patient care by utilizing all elements of the nursing process and/or agency standards of care. Ensures the level of care and services provided coincide with the patients' level of acuity and meet their needs. Ensure assessing clinicians and ancillary staff is providing care within their scope of practice and submits quality documentation authenticating appropriate assessment and intervention provided to the patient. 31. Ensures appropriate action is taken on any suspected abuse and/or neglect cases. 32. Functions in the capacity of Clinical Supervisor, Field Nurse, or Aide when necessary. Completes workflow in client related task, coordination notes, and administrative task for staff who are absent or need additional assistance with completing their workflow. 33. Coordinates with the Outcomes Supervisor to ensure proper care and documentation when Potentially Avoidable Events are detected and to ensure we are progressing towards improving outcomes utilizing Process Quality Measures. 34. Ensure employees complete incident reports when incidents occur as directed in agency policy and procedure and document all follow up related to the incident. Reviews QI reports such as Infection Control Logs to control the spread of infection from staff to patients and documents follow up related to infections; Reviews Occurrence Logs and documents follow-up related to the occurrence; and Reviews Medication Error Logs documenting all follow up related to the error. Counseling/termination may be necessary depending on severity of incident. 35. Ensures staff is compliant with the monitoring of blood glucose machines to ensure proper calibration. 36. Completes clinical related tasks such as entering non-admits, voiding orders, etc as necessary. Runs reports to track Missed Visits and Declined Visits and investigates to ensure patient meets homebound criteria and ensure employee is being compliant with making visits as scheduled. 37. Participates enthusiastically in short and long range planning for the branch and implements specific measures for growth. Is always aware of hospitalizations, discharges, census, and recent admissions. 38. Participates in public relations and community activities that promote the agency's role as an effective member of the health care delivery system. Participates during flu season making the community aware of Influenza and preventative measures offering vaccinations to provide protection to the public. Participates in educating physicians and other community and referral sources. 39. Participates on the peer review committee presenting patient case studies for review. 40. Coordinates closely with immediate supervisor to inform them of any issues within your branch office, receive direction on unusual circumstances, notify them of staffing requirements, include in plans for growth and financial viability, report staff who are not meeting performance expectations, discuss reports associated with EHR, etc. 41. Coordinates closely with contract disciplines and therapy companies to ensure their delivery of care meets all agency, state and federal laws and regulations. Ensures the CS understands their responsibilities with care oversight and is collaborating with therapy. Ensures therapist are meeting care, timelines, and documentation expectations and holding them accountable when expectations are not being met. Seeks to contract with different therapy companies or therapists when expectations cannot be met by current contracted companies. Is responsible to ensure quality care is being provided by all staff and contract employees/companies. 42. Responsible for complying with all Agency Policies and Procedures, State and Federal Laws and Regulations.
Disclaimer:
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities and will be directed by their Area Clinical Supervisor as the need arises.
WORKING CONDITIONS 1. General office. 2. Work is moderate with a combination of sitting, standing, and walking. 3. Travel to other branch offices, designated facilities for training/meetings, and/or patient homes. 4. Community and client home environment. 5. Potential exposure to blood and/or body fluids and infectious disease during the performance of job duties. 6. Potential exposure to extreme temperature and humidity when traveling. 7. Potential exposure to dust, gas, fumes, and odors during traveling. 8. This position has been designated as clinical management (see Infection/Exposure Control Plan). Employees performing clinical management duties may be involved in potential exposure to blood borne pathogens and other potentially infectious materials. All clinical management employees will be offered Hepatitis B vaccination at no expense to the employee.
PHYSICAL REQUIREMENTS 1. Visual and manual dexterity is required 2. Good physical stamina and mental health is required. Has completed the agency pre-employment health clearance. 3. Ability to perform tasks involving physical activity, which may include heavy lifting and extensive bending and standing. 4. Ability to deal effectively with stress. 5. Ability to communicate effectively with staff, patients, family, and physicians through speaking and hearing. 6. Ability to operate office equipment including, but not limited to, computers, printers, copiers, etc.
CONTINUING EDUCATION REQUIREMENTS The Director of Nurses (DON) must meet the required continuing education hours for state certification as a nurse in Texas as applicable. Agency personnel are expected to participate in appropriate continuing education as may be requested and/or required by their immediate supervisor. In addition, agency personnel are expected to accept personal responsibility for other educational activities to enhance job related skills and abilities. All agency personnel must attend mandatory educational programs.Estimated Salary: $20 to $28 per hour based on qualifications.
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