Director of Nursing

Job DescriptionJob Description: The Director of Nursing provides strategic leadership, clinical governance, operational oversight, and administrative direction for all Nursing services throughout EIHAB Human Services. The Director is responsible for establishing, implementing, monitoring, and evaluating systems that ensure individuals receive safe, effective, person-centered healthcare in accordance with professional Nursing standards, applicable OPWDD requirements, agency policies and procedures, and federal and New York State requirements. The Director provides direct leadership and accountability for the Nursing Department, including Residential Registered Nurses, Day Services Registered Nurses, Licensed Practical Nurses, and other assigned Nursing personnel. The Director ensures Nursing staff understand their assigned responsibilities, maintain required competencies, complete required program oversight, and consistently carry out clinical, documentation, medication, training, regulatory, and quality-assurance responsibilities. The Director is responsible for establishing appropriate checks and balances, monitoring systems, supervisory expectations, audits, trackers, performance measures, and follow-up processes to verify that Nursing systems are implemented effectively across all agency services and that identified deficiencies are corrected and sustained. The Director oversees Nursing assessments, Plans of Nursing Services (PONS), Nursing protocols, medical alerts, medication and treatment systems, AMAP requirements, delegated Nursing responsibilities, pharmacy reviews, Medication Regimen Reviews, medical follow-up, immunizations, staff competency, infection prevention, choking and aspiration safeguards, Nursing documentation, healthcare self-audits, incident management, clinical risk, interdisciplinary collaboration, and regulatory readiness. The Director collaborates with the Vice President of Operations, Residential and Day Services leadership, Quality Assurance, Compliance, Human Resources, Training, Clinical Services, physicians, pharmacies, healthcare providers, families, guardians, care managers, and other interdisciplinary partners to ensure coordinated healthcare systems and continuity of care throughout the organization. REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES The Director must possess comprehensive knowledge of Nursing administration, professional Nursing practice, healthcare operations, clinical supervision, medication administration, AMAP systems, delegated Nursing responsibilities, chronic disease management, infection prevention and control, emergency medical response, clinical documentation, healthcare quality improvement, and person-centered services for individuals with intellectual and developmental disabilities. The Director must maintain extensive working knowledge of applicable OPWDD regulations and guidance, New York State Nursing requirements, 14 NYCRR requirements applicable to agency services, HIPAA, individual rights, informed consent, incident management, medication administration, delegated Nursing practices, Human Rights protections, person-centered planning, and other federal and state healthcare requirements. The Director must demonstrate the ability to develop reliable departmental systems, assign responsibility, establish performance standards, monitor completion, identify gaps, enforce accountability, and ensure corrective measures are implemented and sustained. The Director must demonstrate strong leadership, independent clinical judgment, strategic planning, communication, organization, staff-development, problem-solving, conflict resolution, data-analysis, and performance-management skills. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES Nursing Department Leadership and Accountability ● Provide strategic, clinical, and operational leadership for all Nursing services across all agency services. ● Establish Nursing Department goals, priorities, procedures, performance expectations, and quality standards. ● Clearly define responsibilities and caseload expectations for all agency services and other Nursing staff. ● Establish supervisory systems and checks and balances to verify assigned responsibilities are completed accurately and timely. ● Conduct regular Nursing supervision, departmental meetings, case reviews, performance reviews, and individual follow-up with Nursing staff. ● Monitor staff performance through program visits, audit results, documentation, trackers, incident trends, training completion, corrective-action follow-up, and direct observation. ● Address performance deficiencies promptly through coaching, retraining, performance improvement, corrective action, or referral to Human Resources as appropriate. ● Ensure Nursing staff function independently within their assigned responsibilities while maintaining appropriate communication and escalation. ● Develop staffing plans and recommend Nursing resources necessary to support service needs, acuity, regulatory requirements, growth, and continuity of care. ● Promote professional accountability, collaboration, leadership development, succession planning, and continuous improvement throughout the Nursing Department. Agency-Wide Nursing Operations and Clinical Governance ● Direct and monitor Nursing services across all agency programs to ensure consistent clinical standards and healthcare practices. ● Establish systems to ensure individuals receive appropriate Nursing assessment, medical follow-up, treatments, health monitoring, preventive care, and emergency response. ● Ensure Residential and Day Services RNs complete required site visits and maintain appropriate clinical presence within their assigned programs. ● Ensure LPN agency-wide responsibilities, including self-audits, medication-room reviews, staff observations, training, and Nursing support, are completed according to established schedules. ● Review Nursing assignments and redistribute resources when acuity, staffing, service expansion, regulatory findings, or other operational circumstances require adjustment. ● Establish mechanisms for cross-coverage and continuity during vacancies, leave, emergencies, or other staffing disruptions. ● Maintain oversight of Nursing services without assuming routine responsibilities assigned to subordinate Nursing staff except when direct intervention is necessary for clinical safety or operational continuity. Nursing Assessments, PONS, Protocols, and Clinical Monitoring ● Establish and monitor systems ensuring required Nursing assessments, including agency-required semi-annual assessments, reassessments following significant clinical changes, and medication-related Nursing assessments, are completed timely and accurately. ● Ensure PONS, Nursing protocols, healthcare protocols, medical alerts, safeguards, and Nursing directives are current, clinically appropriate, individualized, and reflective of current healthcare needs. ● Ensure Nursing staff regularly review protocol-monitoring data and healthcare outcomes to determine whether interventions remain effective. ● Require timely revision of Nursing plans and protocols when health conditions, physician recommendations, incidents, clinical outcomes, or other circumstances indicate a need. ● Monitor high-risk clinical conditions and ensure appropriate Nursing oversight for individuals with complex or changing healthcare needs. ● Ensure Nursing staff evaluates individuals following hospitalization, emergency department visits, significant health changes, new diagnoses, or other clinically significant events. ● Establish escalation expectations for unresolved clinical concerns, abnormal findings, deterioration in health status, or repeated healthcare concerns. Medical Consultation, Healthcare Follow-Up, and Preventive Care ● Establish systems to ensure all physician and specialist recommendations are reviewed by Nursing and tracked through completion. ● Ensure laboratory testing, diagnostic procedures, specialist consultations, referrals, treatments, medication changes, and return appointments are completed within appropriate timeframes. ● Require Nursing staff to evaluate whether physician and specialist recommendations achieve the expected clinical outcome and initiate additional follow-up when necessary. ● Ensure hospital and emergency department recommendations are appropriately reviewed, implemented, and incorporated into applicable Nursing documentation. ● Ensure changes in diagnoses, treatments, precautions, medications, and recommendations are reflected in PONS, protocols, medical alerts, MARs, and other healthcare records. ● Monitor systems for preventive healthcare, physical examinations, dental care, screenings, immunizations, laboratory testing, and other recommended healthcare services. ● Address recurring missed appointments, delayed follow-up, incomplete documentation, or barriers to healthcare access. Medication, Pharmacy, and Treatment Systems ● Provide overall Nursing oversight of medication administration and treatment systems throughout the agency. ● Establish monitoring systems for medication rooms, storage, inventory, counts, controlled substances, expiration dates, medication availability, MARs, physician orders, treatments, PRN documentation, and other medication-related requirements. ● Ensure routine medication-room inspections are completed and identified deficiencies receive documented corrective follow-up. ● Ensure medication errors, missed doses, refusals, discrepancies, adverse reactions, and other medication events receive appropriate Nursing assessment, practitioner notification, incident reporting, investigation, corrective action, retraining, and follow-up. ● Ensure required Medication Regimen Reviews, consultant pharmacist reports, and pharmacy reviews are obtained, reviewed by Nursing, and followed through resolution. ● Ensure pharmacy recommendations requiring prescriber action are communicated, tracked, documented, and incorporated into applicable medication and Nursing records. ● Monitor systems for medication effectiveness, adverse effects, laboratory monitoring, medication interactions, and other medication-related outcomes. ● Ensure medication self-administration assessments are current and revised when an individual's ability or support needs change. ● Identify recurring medication trends and implement system-wide corrective or preventive measures. Medical Coordinator/Advocate Healthcare Systems ● Establish clear expectations for Nursing oversight of Medical Coordinators/Advocates supporting Residential healthcare coordination. ● Ensure Residential RNs provide appropriate clinical direction while Medical Coordinators/Advocates perform administrative healthcare coordination within established role boundaries. ● Ensure reliable systems exist for scheduling and tracking medical, dental, specialist, laboratory, diagnostic, and other healthcare appointments. ● Require systems for obtaining consultation reports, physician orders, laboratory/diagnostic results, referrals, hospital documentation, medication information, and other required healthcare records. ● Ensure significant healthcare information is provided to the assigned RN promptly for clinical review. ● Monitor outstanding appointments, recommendations, testing, pharmacy recommendations, missing documentation, and delayed follow-up through Nursing supervisory systems. ● Address recurring Medical Coordinator/Advocate deficiencies with Residential leadership and assigned Nursing staff. ● Maintain clear distinction between administrative healthcare coordination and clinical Nursing assessment, interpretation, and decision-making. AMAP Training, Medication Pouring, and Certification Oversight ● Direct and monitor the agency's AMAP Nursing systems and ensure applicable OPWDD and agency requirements are consistently followed. ● Ensure qualified Nursing personnel provide required AMAP training, certification, recertification, competency evaluation, medication pouring observations, remedial education, and follow-up. ● Establish systems for tracking AMAP certification status, expiration dates, required pourings, competency documentation, remediation, and outstanding requirements. ● Ensure staff do not independently administer medications unless applicable training, certification, competency, and authorization requirements have been successfully completed. ● Monitor unsuccessful or overdue pourings, medication errors, repeated competency concerns, and expired certifications. ● Ensure AMAP training, certification, pouring, competency, and remediation records are complete, current, signed, dated, and appropriately maintained. ● Collaborate with Training, Human Resources, and program leadership to prevent assignment of unauthorized employees to medication-administration responsibilities. ● Address systemic AMAP deficiencies and implement corrective measures when trends are identified. Delegated Nursing Responsibilities and Staff Competency ● Ensure delegated Nursing responsibilities are assigned and supervised in accordance with applicable Nursing and OPWDD requirements. ● Ensure RNs appropriately determine whether tasks may be delegated based on the individual's needs, complexity of the procedure, and staff competency. ● Ensure individual-specific education, demonstration, supervised practice, return demonstration, authorization, and documentation occur before delegated procedures are independently performed. ● Ensure required annual clinical competency evaluations are completed and additional reassessment occurs following incidents, clinical changes, medication errors, or performance concerns. ● Establish monitoring systems for delegated Nursing authorizations, competency expiration, staff performance, remediation, and documentation. ● Immediately address identified practices occurring outside an employee's training, authorization, or competency. Staff Education, New Hire Orientation, and Clinical Development ● Direct development and implementation of Nursing orientation, New Hire Orientation, management education, onsite training, competency programs, and continuing clinical education. ● Ensure Nursing staff fulfill assigned teaching responsibilities and use approved, current training materials. ● Ensure staff receive education related to PONS, protocols, medical alerts, medications, healthcare documentation, emergency response, infection prevention, choking prevention, individual-specific health risks, and Nursing notification requirements. ● Establish systems for identifying education needs through incidents, audits, medication variances, clinical observations, documentation findings, regulatory reviews, and changes in individual healthcare needs. ● Develop, approve, and periodically review Nursing policies, training materials, clinical guidance, competency tools, and educational resources. ● Evaluate effectiveness of Nursing education and require retraining or remediation when implementation or competencCompany DescriptionEIHAB Human Services is a multilingual, multicultural nonprofit organization dedicated to serving adults with developmental disabilities and behavioral health challenges. We believe every human being deserves the chance to succeed. Through high quality, compassionate care, we aim to help physically, and mentally challenged individuals lead fulfilling, productive lives.