The position of Lead Community RN is a responsible professional position with program planning, management and supervisory responsibilities over the Community RN’s working with persons served in residential programs operated by the Arc of the Ozarks.
The position functions as a Lead Community RN with overall responsibility for the development, implementation, coordination, and evaluation of medical services for the Arc of the Ozarks while ensuring that medical services are adapted to the needs of persons served in individual residential facilities. The position assists Arc administration, Program Directors, Mid-Level Management, supervisory and direct support staff in providing for the medical needs and care of individuals with intellectual and developmental disabilities, autism spectrum disorder, and psychiatric diagnoses in the residential program.
Work includes responsibility for monitoring the health and safety of the persons served receiving residential services and providing appropriate delegation and supervision of Community RN’s and direct support staff who perform such duties as medication administration and other nursing tasks when applicable.
The Lead Community RN will supervise and coordinate activities of the Community RN’s. The Lead RN will work closely with the Community RN’s to maintain training schedules and expedite work flow of the Community RN’s. The position will inform the VP of Program Services of both progress and potential problems within the Medical Services Department. An employee in this position provides leadership and direction in accordance with agency and Missouri Department of Mental Health policy and procedure. The Lead Community RN will collaborate with ancillary support departments to ensure compliance with agency and DMH policy and procedures. The Lead Community RN will serve as a member of Senior Staff, and serve on key committees related to persons’ served health and safety. Participates in agency performance improvement goals through utilization of identified Key Performance Indicators and trend analysis as directed by the VP of Program Services and VP of Quality Management. Additional responsibilities include the development and monitoring of the design, evaluation and monitoring strategies for the delivery of effective medical services, assuring that standards for licensure, certification and/or accreditation are met and maintained; and supervising assigned staff, and implementing active medical treatment programs. The employee will oversee the Arc of the Ozarks psychiatric clinic while working collaboratively with contracted psychiatrists to ensure continuity of service for persons served in the residential program.
The employee consults with administrative officials, program staff and other employees and outside agencies including the Department of Mental Health, Regional Office Quality Management RN’s and Quality Management personnel in coordinating and implementing The Arc of the Ozarks Quality Management Program and ensuring the State Department of Mental Health Division of Developmental Disabilities Community RN Regulations and Guidelines are followed per Agency contract.
General supervision is received from the Vice-President of Program Services or other designated superior; however, the employee is expected to exercise independent judgement and initiative within the limit of established guidelines and procedures. The Lead Community RN is an exempt, salaried position.
Essential Job Functions
(Any one position may not include all duties listed nor do the listed examples include all tasks which may be found in positions of this class.)
- Supervises Community RN’s in the delivery of each person’s served plan of care, including medical services; integrating the various aspects of the programs; recording each person’s served progress; and initiating periodic reviews of each person served support plan and their medical needs.
- Participates with the Vice President of Program Services and other administrative staff in formulation and implementation of administrative procedures, rules, and regulations pertinent to program medical services.
- Directs and supervises the Medical Services Department of the Arc of the Ozarks to ensure medical practices and procedures conducted by the staff of the Arc are followed and in compliance as required per agency contract with the Missouri Department of Mental Health.
- Keeps the Vice President of Program Services informed through periodic reports concerning various phases of the medical services program.
- Designs, constructs, and participates in the development of the Agency medical programs that meet long and short-range program planning goals; implements, coordinates, and evaluates medical programs adapted to the individual needs of all assigned persons served; and prepares a monthly department report to be submitted to the Vice President of Program Services.
- Responsible for ensuring and tracking the Community RN and Medical Fragile Program RN monthly summaries on persons served are completed, accurate and submitted to appropriate Case Management Entities by the required time frame.
- Reviews reports, and related information developed by the Quality Management team regarding critical incidences such as falls, choking incidences, hospitalizations, PRN psychotropic medication use, and incidences of crisis intervention techniques, to determine and implement prevention strategies with the Community RN’s and support teams.
- Responsible for working closely with the Arc of the Ozarks Accounting Department to ensure monthly nursing logs are entered into the billing system by the deadline each month and submitted for retention and auditing purposes. Ensure that Community RN’s and Medically Fragile RN’s provide the specified number of hours of nursing time per month to each person served in residential services based on their approved individualized support plan. Documents monthly expended time and activity for auditing purposes.
- Develops an on-call system for Community RN’s to ensure capacity support after agency hours and weekends as a resource for staff when a person served experiences a medical crisis or life-threatening emergency.
- Oversee the Arc of the Ozarks psychiatric clinic while working collaboratively with contracted psychiatrists to ensure continuity of service for individuals served in the residential program.
- Provides assessment, nursing diagnosis, nursing care, and counsel of persons served who are ill, injured, or experiencing alterations in normal health processes.
- Oversees all functions of medication administration by certified Medication Aides, including but not limited to monthly review of physician’s orders, medication administration record, staff documentation, and periodic inspection of technique and skill of each certified aide delegated to pass medications, procedures, and medication storage.
- Per Agency and DMH policy oversees and works closely with the training department to track all functions of delegated nursing tasks to direct support staff.
- For delegated nursing tasks, ensure that all Community RN’s and Medically Fragile RN’s are following a consistent standard of competency as determined by the Lead Community RN and Training Department and that the nurses are assuring the person performing the task has been educated/trained and demonstrates competency; and provides necessary documentation and periodic inspection of the assigned task as recommended by the National Council of State Boards of Nursing (NCSBN).
- Responsible for ensuring coordination and assistance in the delivery and implementation of a plan of health care with all members of the medical department of the persons served.
- Competes a monthly assessment of each person served to evaluate health concerns and identify changes in their health status.
- Ensures that a summary of each person served upon being discharged from residential services is completed by the Community RN’s and submitted to the Quality Management Department.
- Ensure that members of the medical services department monitor the application of all physicians' orders including but not limited to treatments, procedures, labs, appointments, specialized diets, and adaptive equipment for each person served.
- Provides medication administration instruction to employees and others assigned in medication administration classes according to the guidelines and content prescribed, and approved, by the Missouri Department of Mental Health.
- Implement a system within the Nursing Department that ensures specialized training classes and certifications for direct support staff such as insulin, catheter, feeding tube, etc.as dictated by the medical needs of persons served is being completed and submitted to the Training Department.
- Conducts periodic visits to facilities and programs conducted by the Arc to review the medical records of persons served as well as to monitor the medical practices of the facility or program.
- Ensure that the Medical Services Department inspects and evaluates all adaptive equipment and protective devices prescribed for the persons served to ensure that this equipment is in proper working order and is adjusted properly and regularly provides periodic screenings for tardive dyskinesia, fall risks, and other observed side effects because of psychotropic medication.
- Works in collaboration with the Quality Management Nurses at the Regional Offices for the promotion of the health and safety of each person served and serves as the delegated point of contact for the department to complete State Nurse evaluations, to submit follow-up as needed or complete a plan of action that may result as related to medical needs of persons served.
- Performs other related work as assigned.
Supervises Community RN’s and other staff in implementing Individualized Support Plans and the medical supports needed for assigned program participants; observes staff interaction with all the assigned persons served; and prepares performance evaluations of all assigned Community RN’s.
Required Knowledge, Skills, and Abilities
- Ability to exercise good judgement and maintain confidentiality.
- Ability to work with and respect persons with intellectual and developmental disabilities, autism spectrum disorder, and individuals with psychiatric diagnoses.
- Ability to work varied and flexible hours, accept and adapt to changes in assignments, methods, policies, etc.
- Considerable knowledge of the principles and practices of nursing, developmental disabilities, and allied disciplines involved in the evaluation, care and habilitation of persons with disabilities and psychiatric diagnosis.
- Extensive knowledge of medications commonly prescribed in the care and treatment of persons with intellectual and developmental disabilities, autism spectrum disorder and individuals with psychiatric diagnoses. Such knowledge shall include the intended and unintended consequences derived from the use of such medications by persons served by the Arc.
- Ability to direct, coordinate, and supervise harmoniously the work of professional and non-professional employees.
- A working knowledge of the medical community in the Arc of the Ozarks service delivery areas including what medical services are available to persons served by the organization.
- Ability to collect and analyze information in making decisions concerning medical treatment and progress for each person served.
- Ability to communicate effectively in oral and written form.
- Ability to establish and maintain effective working relationships with persons served, co-workers, direct support staff, other health care professionals, parents, guardians, etc.
Minimum Experience and Training Qualifications
Six years of professional nursing experience as an RN in the provision of nursing services in one or more of the following settings: hospital, long-term care facility, community health facility or similar setting (three of which must be in a management capacity) in working with persons with developmental disabilities.
The licensee shall not be subject to current disciplinary action such as censure, probation, suspension or revocation and shall be in good standing with the Missouri State Board of Nursing.
Current CPR Certification and training in Abuse and Neglect, Positive Behavior Supports, Crisis Intervention Skills and an understanding of the Health Insurance Personal Portability Act (HIPPA) is a plus.