Director of Nursing at John B Parsons Home – SALISBURY, Maryland

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The John B. Parsons Assisted Living Community, located in Salisbury, is recognized as one of the leading senior living communities on the Eastern Shore of Maryland providing gracious living and professional care for over 100 years. Residents continue their independent lifestyle in a safe and supportive environment providing superb care and peace of mind. Congratulations to John B Parsons of Harrison Senior Living whose employees have voted them a "GREAT PLACE TO WORK" through the Activated Insights® Survey Group. They are also the winner of Coastal style award for four years in a row.

The Director of Nursing (DON) serves concurrently as the program’s Delegating Nurse (DN). This role provides full clinical oversight of the Assisted Living program, ensures compliance with all applicable Maryland COMAR 10.07.14 requirements, and manages the Nursing department, staffing, and budget. The DON/DN is accountable for resident outcomes, regulatory compliance, and safe delegation of nursing tasks. This position requires 24/7 availability for clinical consultation and urgent calls from front-line staff (including CMTs) and coordination of qualified on-call coverage when unavailable. This position reports to the Executive Director.

Essential Functions:

1) Delegating Nurse (DN) — Clinical Oversight

• Serve as the licensed DN of record and maintain all qualifications and training required by the Maryland Board of Nursing.
• Manage clinical oversight of resident care, including issuing clinical/nursing orders and ensuring appropriate implementation.
• Be on-site to observe each resident at the required regulatory interval and ensure ongoing clinical supervision of delegated tasks.
• Maintain 24/7 clinical availability (or ensure qualified alternate DN coverage) for staff escalations regarding resident status changes, medication administration issues, and emergent clinical concerns.
• When an order cannot be implemented as written, collaborate with the Assisted Living Manager (ALM) and the health care practitioner to identify safe alternatives; ensure documentation and required notifications.
• Ensure the RN on-site review cadence required for residents whose medication administration is delegated to unlicensed staff/CMTs; provide recommendations to the prescriber and ALM.
• Coordinate with on-site nursing personnel to ensure adequate assessment, medical services planning, and oversight of nursing activities.

2) Resident Assessment, Service Planning & Care Transitions

• Oversee and perform nursing assessments in alignment with COMAR timeframes: admission/pre-admission processes, routine 6-month reviews, annual reassessments, post–significant change assessments, and readmission assessments.
• Review, co-sign, and update service plans to reflect clinical status, risk factors, and special care needs (e.g., falls, pressure injury risk, diabetes, oxygen therapy, enteral feeds, Foley/ostomy care, therapeutic drug levels, mental illness, and behaviors that may disrupt or harm).
• Determine and document awake overnight staffing needs per assessment guidelines; participate in any electronic monitoring waiver processes if applicable.

3) Medication Management & Delegation

• Oversee medication administration systems: ensure CMT training, certification, and competency; maintain compliance with RN delegation and supervision requirements.
• Conduct/ensure required medication regimen reviews and pharmacist reviews; implement recommendations and mitigate medication errors, side effects, and potential interactions.
• Perform quarterly reassessments for residents who self-administer with reminders/assistance and for residents administering to a spouse/domestic partner as permitted.

4) Documentation, Quality Assurance & Reporting

• Ensure compliance with resident record requirements (e.g., assessments, nursing notes, orders, service plans, care notes, weights, pharmacy reviews, rehab plans).
• Ensure appropriate staff write individualized weekly care notes and additional notes at all required triggers (admission, significant change, transfers, appointments, etc.).
• Lead quality assurance activities, trend incident reports/events, and implement corrective actions.
• Oversee timely completion and retention of incident reports; ensure appropriate notifications (resident/representative, prescriber, DN, OHCQ, law enforcement, etc., as applicable).

5) Staffing Leadership & Scheduling

• Develop, implement, and manage the staffing plan based on resident acuity and service needs, including on-site 24-hour coverage, awake overnight staffing when required, and relief personnel.
• Create monthly/weekly/daily schedules for nursing, CMTs, CNAs/GNAs, and other care staff; ensure staffing schedule retention per regulation.
• Recruit, hire, coach, evaluate performance, and conduct corrective action; ensure required orientation, annual training, and competency validation.

6) Education, Training & Competency

• Provide/oversee initial and ongoing training programs: CPR, infection prevention, fire/life safety, food safety, emergency disaster plans, cognitive impairment/mental illness/behavioral health content, and any unit-specific/Alzheimer’s Special Care Unit requirements as applicable.
• Validate competencies for personal care tasks when performed by employees other than CNAs/GNAs before independent practice (or within permitted supervised timeframe) and maintain documentation.

7) Communication, Care Conferences & Family Relations

• Coordinate family/resident care conferences with the Executive Director; serve as liaison with residents, representatives, providers, and interdisciplinary team members.
• Maintain professional, timely communication and ensure dignified, person-centered services aligned with resident preferences and rights.

8) Program Administration & Fiscal Stewardship

• Manage the clinical budget (labor, supplies, pharmacy consulting, outside services) and monitor utilization.
• Maintain policies/procedures consistent with standards of care and COMAR; conduct mock surveys and readiness activities.
• Ensure mandatory reporting to the State and compliance with all OHCQ directives.

Management/Supervisory:

• Oversee entire Nursing department.
• Medication Technicians, CNAs, CMAs, resident care providers and/or LPN.
• Requires routine on-site presence, with 24/7 availability for clinical consultation and crisis escalation. When unavailable, arranges qualified alternate DN coverage per policy. Participates in weekend/holiday rotation as needed

Driving Requirements:

• Must be able drive and use personal vehicle. Milage reimbursement offered.

Level of Education:

• BSN preferred; ASN accepted with strong senior-care leadership history.

Professional Qualification:

• Positive; Able to manage multiple high-level tasks such as scheduling staff; scheduling care conferences and maintaining communication with staff and families in a professional, positive manner.
• Must maintain CEU and other state requirements for the position, as applicable.

Technical or Professional License(s)/Certification(s)

• Current Maryland RN
• Maryland Delegating Nurse Certification
• Current CPR

Level of Experience

• 5+ years as DN or 10+ years nursing leadership in senior care; demonstrated management of staffing plans, delegation to CMTs, and survey readiness.

General Knowledge/Skills/Abilities

• Must be able to speak and understand English.
• Display positive attitude toward the residents, visitors, staff and families.
• Ability to communicate with residents and remain calm under stress.
• Ability to understand and apply training and in-service education.
• Scheduling and budget management.
• Proficiency with EHR/clinical documentation systems and HRIS.

We are proud to be an EEO employer M/F/D/V. We maintain a drug-free workplace. We do not discriminate in services or employment on the basis of race, color, religion, ancestry, national origin, sex, sexual orientation, gender identity, age, disability, past or present receipt of disability-related services or supports, marital status, veteran status, or any other class of persons protected by federal, state or local law.