Director of Nursing & Home Health Administrator - (Hands-On RN)

JOB DESCRIPTION / PROFILE

DIRECTOR OF NURSING & HOME HEALTH ADMINISTRATOR - (HANDS-ON RN)

Job Title: Director of Nursing & Home Health Administrator - (Hands-On RN)

FLSA Status: Exempt (Salaried)

Department: Home Health Operations & Clinical Services

Direct Report: Agency Owner

Supervises: RN Case Managers, LVNs, Therapists, Scheduler/Back-Office Staff

Location: On-site patient visits & remote work with transition to office location

Statement of Purpose:

The Director of Nursing & Home Health Administrator is a dual-role RN leader who performs OASIS-required patient assessments (Start-of-Care, Recertification, Resumption-of-Care, Discharge) and selected skilled-nursing visits. This role requires high-quality, compassionate care to promote the health and well-being of patients while adhering to agency policies and regulatory standards.

Directs day-to-day business operations as the Medicare-certified Administrator, ensuring financial, regulatory, and strategic goals are met. Leads clinical services as Director of Nursing / Clinical Manager, providing professional oversight, quality assurance, and staff development.

The role is salaried to reflect the integrated leadership and field responsibilities rather than pay-per-visit production, and requires a self-starter mindset to solidify and maintain our home-health presence across the San Antonio metro area.

In addition to the qualifications below, the ideal candidate is equipped with problem-solving skills, analytical and critical thinking abilities, and the capacity to manage multiple tasks simultaneously. They excel in organizational endeavors, effortlessly balancing various responsibilities with precision. Their interpersonal finesse fosters effective communication, facilitating seamless collaboration within the team and interactions with patients and families. Above all, the ideal candidate embodies unwavering honesty and integrity, essential traits in maintaining trust and ethical standards within the healthcare environment.

Please note: This job role has been identified as potentially exposing employees to blood, body fluids, or other potentially infectious materials during regular duties. As a result, individuals in this role are deemed to be at risk of exposure. They will be offered the opportunity, at no expense to themselves, to receive the Hepatitis B vaccine according to standard medical guidelines within ten (10) days of starting their employment.

Essential Tasks, Duties, & Responsibilities:

• Supervision:
• Oversee agency operations, staffing mix, and vendor contracts.
• Ensure adherence to federal, state, and payer requirements; maintain current licenses, contracts, and insurance.
• Prepare and present monthly operational reports for leadership review.
• Drive census and service-line growth targets in collaboration with the Marketing Team while safeguarding quality-of-care metrics.
• Establish and maintain policies for admissions, billing, privacy, and record retention.
• Supervise RN Case Managers, LVNs, Therapists, and Scheduler/Back-Office Staff to ensure the plan of care is executed.
• Conduct routine chart audits to update medication sheets and care plans.
• Clinical Duties:
• Conduct SOC, Recert, ROC, and Discharge OASIS assessments and ensure accuracy and timely submission.
• Provide direct skilled-nursing care per plan of care (e.g., med administration, wound care).
• Document all care in EMR within 24 hours, ensuring concise, accurate observations.
• Educate patients/families on disease management, meds, safety, and discharge planning.
• Assess patient physical, psychological, social, and environmental status.
• Administer medications, treatments, and procedures as prescribed.
• Monitor patient conditions and report changes to the attending physician or designee.
• Maintain proficiency in clinical skills.
• Coordination, Communication, and Documentation:
• Maintain clinical policies & procedures to meet Medicare CoPs (42 CFR § 484), Texas TAC § 558, and payer standards.
• Chair interdisciplinary team meetings, case conferences, and quarterly QAPI reviews.
• Monitor KPIs: hospitalization rate, infection control trends, on-time OASIS, visit productivity.
• Recruit, orient, schedule, evaluate, and mentor all clinical personnel; ensure competency checks.
• Lead emergency preparedness, infection-control, and patient-safety programs.
• Serve as primary clinical contact during surveys and audits; coordinate Plans of Correction.
• Coordinate all services related to providing skilled nursing care.
• Report pertinent observations and reactions regarding changes in patient status to appropriate team members and provide follow-up to assure resolution.
• Complete and submit accurate and timely documentation of patient care, observations, and interventions.
• Maintain accurate and concise patient records in accordance with agency policy and regulatory requirements.
• Participate in team conferences, quarterly utilization reviews, and verify medical necessity and homebound status.
• Collaborate with physicians, pharmacy staff, and administration regarding patient care.
• Communicate effectively with patients, families, and healthcare team members.
• Compliance & Quality:
• Lead agency QAPI program; track corrective actions.
• Conduct regular chart and field audits; implement performance-improvement plans.
• Maintain HIPAA compliance and safeguard PHI.
• Coordinate external surveys, accreditation activities, and cost-report preparation.
• Adhere to all agency policies, procedures, and protocols.
• Ensure compliance with local, state, and federal regulations and standards of practice.
• Utilize appropriate resources efficiently and attend regular staff and safety meetings.
• Follow rules, policies, procedures, and instructions.
• Accomplish goals effectively and adhere to scheduled hours.
• Demonstrate accuracy and quality of work.
• Demonstrate job knowledge and application for position.
• Demonstrate organizational skills and timely assignment completion.
• Effective management of stress and congeniality in the work environment.
• Interpret agency philosophy and policies to patients, families, and other groups.
• Training and Education:
• Assist with orientation and training of employees.
• Educate patients and families on health care needs, medication management, and safety measures.
• Community Engagement:
• Cultivate relationships with physicians, hospitals, skilled-nursing facilities, and payers.
• Represent the agency at professional associations, community events, and networking forums.
• Utilize appropriate community resources, identify new resources, and share information with colleagues.
• Promote good public relations with referral sources.
• Miscellaneous:
• Perform additional duties and other essential job functions as assigned.
• Maintain compliance with continuing education requirements.

Please note: The statements above provide a general overview of the essential job duties for this role, but do not encompass all of the specific tasks and requirements associated with the position. Therefore, it is important to note that this list is not, and should not be, considered comprehensive.

Travel Requirements:

• Regular travel (including in adverse weather) is expected to perform this job, and all employees are required to have a valid driver’s license with a properly insured and reliable vehicle.

Work Environment:

• Includes both in-office and home visits.
• Exposure to various home environments and conditions.
• Potential exposure to infectious diseases and hazardous materials.

Physical Demands:

• Frequent talking and listening.
• Ability to perform physical tasks such as lifting, positioning, and transferring patients.
• Occasional lifting and/or moving of objects weighing up to 50 pounds.
• Frequent sitting, standing, walking, bending, and reaching.
• Manual dexterity to operate medical equipment and perform nursing procedures.
• Specific vision ability to adjust focus under various lighting conditions.

Qualifications for Employment:

• Education & Licensing:
• Graduate of an accredited nursing program.
• Current RN license issued by the State of Texas.
• Current and valid BLS or CPR certification.
• Experience:
• Minimum of three (3) years nursing experience within the past 60 months, preferably in home health or community health with OASIS proficiency.
• Minimum 1 year supervisory/management experience meeting TAC § 558 and 42 CFR § 484.115 qualifications for Administrator & Clinical Manager.
• Completion (or commitment to complete within 90 days) the 8-hr/16-hr Texas HCSSA Administrator course.
• Knowledge of Medicare CoPs, OASIS-E, PDGM, and Texas home-health regulations.
• Knowledge of nursing procedures, treatments and techniques.
• Understanding and ability to perform basic charting procedures.
• Demonstrated survey readiness and QAPI leadership.
• Skills:
• Exhibits proficiency in motivational strategies and exemplary leadership skills.
• Strong clinical skills and knowledge of nursing practices.
• Excellent communication and interpersonal skills.
• Ability to work independently and manage time effectively.
• Proficient in the use of electronic medical record systems and other healthcare software.
• Other Requirements:
• Successful background check, drug screen, TB screening, and immunization compliance.
• Ability to maintain confidentiality and comply with HIPAA regulations.
• Must hold a valid driver’s license with a properly insured and reliable vehicle.
• Available during normal business hours and on-call rotation (24/7) as required.
• Ability to lift/transfer up to 50 lbs and perform physical patient-care tasks.

Employer's Rights:

• The employer reserves the right to modify, interpret, or apply this job description in any way the agency desires.
• This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position.
• Employees may be asked by supervisors or managers to perform other job duties.
• This job description is not an employment contract, implied or otherwise. The employment relationship remains "at-will."
• The employer will evaluate employees based, in part, on their performance of tasks listed in this job description, and has the right to revise this job description at any time.
• The employer and/or employee may terminate employment at any time, for any reason.

Job Types: Full-time, PRN

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

License/Certification:

• RN License for the State of Texas (Required)

Ability to Commute:

• San Antonio, TX 78216 (Required)

Work Location: In person