Director of Nursing, Skilled Nursing

SOUTHERN INYO HEALTHCARE DISTRICT•Lone Pine, CA

1d•Onsite

About The Position

The Director of Nursing (DON) plans, organizes, directs, controls, and coordinates nursing and health services at Southern Inyo Healthcare District’s 33-bed Skilled Nursing Facility in Lone Pine, California. The DON is the designated full-time Registered Nurse responsible for the facility’s nursing services under federal and California requirements and reports to the Chief Nursing Officer (CNO) or CEO designee. The role oversees the nursing leadership team, staffing, staff development and CNA training, MDS and care planning, infection prevention, medication safety, QAPI, and survey readiness. The position is accountable for resident and family satisfaction, staff morale, quality, organization, regulatory compliance, and collaboration with District departments including Quality, Compliance, and Patient Financial Services. The DON directs SNF nursing services and exercises independent clinical and managerial judgment within District policy and delegated authority. The position makes or recommends hiring, discipline, promotion, and separation decisions in accordance with District policy and Human Resources review; it does not independently approve compensation changes or make decisions outside delegated authority. Resident-safety events, suspected abuse or neglect, survey and compliance concerns, staffing shortfalls, significant outcomes, and HIPAA or privacy concerns must be escalated promptly to the CNO or CEO designee and other applicable leaders. The role is based in the Skilled Nursing Facility and administrative offices. Work may involve frequent interruptions, on-call availability, work beyond regular hours, weekends and holidays, and temporary work in other positions as necessary. The DON may encounter hostile or emotionally upset residents, family members, and others; falls, equipment burns, odors, infectious waste, diseases, and bloodborne pathogens. Physical activity may include sitting, standing, bending, lifting, pushing, pulling, stooping, walking, reaching, and moving intermittently, as well as lifting, moving, or transferring residents, including lifting up to 50 pounds occasionally. Reasonable accommodation will be considered consistent with applicable requirements.

Requirements

Current, valid, unrestricted California Registered Nurse license issued by the California Board of Registered Nursing, maintained in good standing throughout employment.
Bachelor of Science in Nursing (BSN).
Eligible to serve as the designated full-time Director of Nursing under 42 CFR §483.35(b), Health & Safety Code §1250(c), and Title 22 CCR §72103.
At least two years of experience in a skilled nursing facility nursing leadership role.
CPR/BLS certification upon hire or obtained during orientation, and kept current during employment.
Knowledge of nursing administration practices and procedures and the laws, regulations, and guidelines governing nursing administration in skilled nursing facilities.
In-depth knowledge of healthcare legal policies and regulations, including 42 CFR Part 483, California Title 22, and Health and Safety Code staffing requirements.
Knowledge of geriatric and post-acute clinical care, MDS and care planning, infection prevention, and medication safety.
Knowledge of budgeting, staffing, labor relations, and employment law as they apply to nursing leadership.
Knowledge of QAPI methods and survey readiness.
Ability to lead, motivate, and hold a nursing team accountable and function at an expert level in the field of practice.
Ability to make independent decisions when circumstances warrant and exercise sound judgment under pressure.
Ability to communicate effectively with physicians, residents, families, regulators, nursing staff, and other leaders.
Ability to respond to common inquiries or complaints from residents, patients, physicians, peers, regulatory agencies, or members of the business community.
Ability to collect, analyze, and manage data and use it to drive improvement.
Ability to work independently and collaboratively and manage multiple priorities in a small rural facility.
Ability to read, write, speak, and understand English and communicate clearly orally and in writing.
Ability to lift, move, or transfer residents as necessary, including assistance with mobility, and lift up to 50 pounds occasionally; more when using assistive devices or a team lift.
Ability to sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours.
Satisfactory completion of employment conditions under HR-032, including required criminal background clearance, drug test, tuberculosis and other required health clearance, physical exam, and satisfactory references.
Ability to meet immunization and health-clearance requirements applicable to long-term-care personnel.
Ability to work independently and respond to common inquiries or complaints from residents, families, physicians, peers, and regulatory agencies.

Nice To Haves

Master’s degree in Nursing, Healthcare Administration, or a related field.
Long-term care or gerontological nursing certification, including Director of Nursing Services–Long Term Care (DNS-LTC) or similar.
Experience with regulatory surveys, plans of correction, and QAPI in a skilled nursing facility.
Experience as a Director of Staff Development or Infection Preventionist.
Experience in a rural or small-facility setting.
Bilingual English and Spanish communication skills.

Responsibilities

Maintain SNF Operations Guidelines by reviewing, writing, and updating policies and procedures.
Oversee SNF operations by initiating, coordinating, and enforcing program, operational, and personnel policies and procedures.
Ensure compliance with state and federal regulations and investigate and correct problems, issues, and concerns.
Serve as the designated full-time Director of Nursing for the facility and only this facility.
Review and audit dietary, pharmacy, and resident medical records, documenting and communicating actions, irregularities, and continuing needs.
Attend and document SNF Quality Assurance and Infection Control meetings and lead nursing participation in QAPI.
Oversee quarterly medical reviews and ensure physician orders, visits, and medication regimen reviews are completed and acted on.
Review clinical outcome indicators monthly, including falls, pressure injuries, weight loss, antipsychotic use, infections, and hospital transfers, and direct improvement actions.
Develop and interpret infection-control policies and protocols and oversee infection prevention and antibiotic stewardship programs.
Review and enforce medication administration and storage procedures and controlled-substance regulations in partnership with the Pharmacist-in-Charge.
Ensure nursing compliance with patient safety, infection prevention, and sanitation procedures, rules, and regulations in partnership with EVS and Life Safety teams.
Ensure allegations of abuse, neglect, or exploitation are reported and investigated as required by law.
Plan and post nursing staffing to meet minimum direct care service hours per patient day, resident acuity, and regulatory requirements, and review Payroll-Based Journal data.
Participate in staff screening, interviewing, and selection, and make or recommend hiring, discipline, promotion, and separation decisions.
Conduct annual staff evaluations and periodic job-description reviews.
Develop and oversee the Director of Staff Development (DSD); support the DSD in developing and running training programs, the CNA certification program, and staff in-service training.
Define, direct, and supervise the nursing leadership team, including the RN Clinical Care Coordinator, Charge Nurses, MDS Coordinator, Social Services, Activities Director, and DSD.
Conduct regular SNF department meetings with broader SNF leadership, including EVS, Dietary, Quality, and Nursing leaders, covering clinical, social, environmental, and operational matters.
Ensure daily morning huddles are held and are informative and productive.
Identify resident care requirements and coordinate services with community agencies, physicians, families, residents, and other departments.
Supervise resident admissions, assessments, MDS, discharge planning, the Activities Program, and care plans for all SNF residents.
Ensure the RN Clinical Care Coordinator maintains regular communication with the Medical Director about resident care, policy, and provider issues.
Direct Dietary Services jointly with the Dietary Manager and Consultant Dietitian on nutrition and weight concerns.
Participate in the annual nursing budget and monitor labor hours, overtime, agency use, supplies, and equipment against budget.
Partner with the District Quality Department on responses to regulatory surveys and the development and implementation of plans of correction.
Ensure adherence to plans of correction in conjunction with Quality Department recommendations and oversight.
Immediately report suspected abuse, neglect, exploitation, and resident-safety events as required by law and District policy.
Maintain confidentiality of proprietary and confidential information and comply with HIPAA and District privacy policies.
Participate in the Compliance Program and Code of Conduct and not participate in or allow retaliation against good-faith reporters.
Complete compliance training and follow District policies, including harassment and compliance procedures; demonstrate integrity, professionalism, team-building, customer service, and a positive attitude.
Perform other related duties reasonably related to the position and consistent with the incumbent’s license, qualifications, department needs, and CNO direction.