ASSISTANT DIRECTOR OF NURSING JOB DESCRIPTION

Nursing unit compliance, staffing ratios, and resident safety outcomes in long-term care facilities all drift when no one holds the floor accountable between the Director of Nursing and front-line staff. The Assistant Director of Nursing owns that accountability layer. Occupying a formal deputy position within the nursing department of a skilled nursing or post-acute care facility, this role carries authority over daily staffing grids, Quality Assurance Performance Improvement programs, and regulatory inspection readiness under state and federal long-term care guidelines. Few nursing management roles require simultaneously managing MDS documentation compliance and conducting Root Cause Analysis on safety events.

As the Assistant Director of Nursing, you will share 24-hour operational accountability with the Director of Nursing for the safety, regulatory compliance, and care quality delivered across all nursing units in a long-term care or post-acute setting. The department's staffing patterns, QAPI outcomes, and nursing staff development fall within this role's direct scope, with a reporting line to the Director of Nursing.

Career Impact: Managing QAPI programs and regulatory inspection preparation at the ADON level builds the clinical leadership credentials that distinguish candidates for Director of Nursing roles in skilled nursing and post-acute care markets.

Business Impact: Residents, families, and state surveyors rely on this role's daily oversight to ensure that care plan compliance, incident reporting, and infection control standards are met consistently across every unit.

Growth Opportunity: Exposure to MDS coordination, worker compensation case management, and interdisciplinary team leadership expands the scope of skills that qualify candidates for DON and multi-site clinical operations positions.

• Oversee daily staffing grids and adjust nurse-to-resident ratios in response to patient census shifts and acuity data.
• Develop and maintain the facility's Quality Assurance Performance Improvement program, analyzing Quality Indicator data to implement corrective action.
• Conduct Root Cause Analysis for precursor and serious safety events and track plans of correction through to resolution.
• Supervise, evaluate, coach, and discipline nursing team members in collaboration with the Director of Nursing.
• Coordinate nursing staff orientation, competency validation, and continuing education to maintain licensure compliance.
• Perform daily rounds on all nursing units to monitor care standards, documentation accuracy, and policy adherence.
• Assist the Director of Nursing in preparing the department for regulatory inspections and developing compliance plans.
• Serve as acting Director of Nursing during absences, assuming full departmental accountability.

• Bachelor's degree in nursing or equivalent work experience in a clinical leadership setting.
• Three or more years of nursing experience in a long-term care or post-acute environment, with at least one year in a supervisory or management capacity.
• Current Registered Nurse licensure in good standing as required by the state of practice.
• Current CPR certification from an accredited provider.
• Working knowledge of long-term care regulations, including state and federal guidelines governing skilled nursing facilities.
• Demonstrated ability to manage staffing grids, conduct performance evaluations, and lead disciplinary processes.
• Strong written and oral communication skills with the ability to interact effectively with residents, families, staff, and regulatory agencies.
• Proven critical thinking and problem-solving skills applicable to clinical and operational decision-making.

• Bachelor of Science in Nursing with a master's degree in nursing or a health-related field completed or in progress.
• Certification in gerontological nursing or a related clinical specialty recognized by a national certifying body.
• Experience coordinating MDS assessments, RAPS, and care plan development in a skilled nursing or subacute care facility.
• Familiarity with infection control program management and CDC guidelines applicable to long-term care populations.

• Staffing grid fill rate, measuring how consistently budgeted shift coverage is achieved against census.
• QAPI corrective action closure rate, tracking the percentage of identified deficiencies resolved within target timelines.
• Regulatory inspection deficiency count per survey cycle, reflecting the department's compliance posture.
• Incident report documentation turnaround time, measuring completion within required reporting windows.
• Nursing staff licensure and certification compliance rate, tracking current credentials across all unit personnel.
• Typical tools: care management platforms (commonly PointClickCare or MatrixCare); scheduling systems (commonly ShiftWizard or similar nurse scheduling software).

• Base Salary Range: $85,000 to $110,000 annually, depending on experience and facility size
• Bonus: Annual performance bonus of 5% to 10% of base salary
• Equity: Not typically offered in long-term care settings
• Health Benefits: Medical, dental, and vision coverage; employer contribution varies by facility
• PTO: 15 to 25 days per year, including holidays
• Common Perks: Continuing education reimbursement, tuition assistance, shift differentials, and licensure renewal support

Figures are estimates based on general US market benchmarks and may be outdated. Adjust based on location, company size, and seniority level.

Employment in this role is contingent on successful completion of a background check and, where required by state regulation, a drug screening consistent with long-term care facility standards. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other characteristic protected under applicable federal, state, or local law. Reasonable accommodations are available to individuals with disabilities throughout the application and employment process. Candidates must be authorized to work in the United States.

The Assistant Director of Nursing leads nursing quality assurance, infection prevention, and daily staffing coordination while sharing 24-hour accountability for standards of care with nursing leaders across all units. Reporting to the Director of Nursing, this role shapes clinical outcomes through Root Cause Analysis, corrective action planning, and professional development of nursing team members in a long-term or subacute care setting.

Key Responsibilities

• Promote nursing philosophy, model of care, and standards of nursing practice.
• Plan for safe, effective, efficient, appropriate, and therapeutic nursing care.
• Ensure nursing department compliance with facility policies and procedures in collaboration with the DON.
• Complete walking rounds on all units.
• Share 24-hour accountability for meeting standards of care with nursing leaders.
• Track resident and patient acuity levels for daily staffing patterns and recommend appropriate staffing levels to the DON.
• Assist with planning, developing, organizing, and implementing departmental goals and objectives.
• Assure nursing team member documentation complies with facility policies and procedures and participate in chart reviews.
• Promote effective liaison relationships between the nursing team and other health team members and collaborate across departments to improve quality and safety of care.
• Develop, implement, and maintain a Quality Assurance Performance Improvement program, analyze Quality Indicator data, and implement corrective action to improve clinical processes and outcomes.
• Assist with developing and implementing action plans to improve compliance with infection prevention and control standards of practice.
• Conduct thorough investigations of occurrences, participate in Root Cause Analysis for safety events, and assist with tracking, analyzing, reporting, and implementing plans of correction.
• Assist with interviewing applicants for nursing positions and demonstrate proficiency in human resource management.
• Evaluate, coach, counsel, and discipline nursing team members and assist with conducting investigations and disciplinary actions.
• Promote professional growth and development of nursing team members and support nursing educational programs.

Required Qualifications

• Graduate of an accredited RN nursing program with current licensure.
• Baccalaureate and master's degree in nursing preferred.
• Minimum of two to three years of nursing experience in an administrative or supervisory capacity.
• Long-term or subacute care facility experience preferred.
• Prior experience with geriatric and rehabilitative populations preferred.
• Knowledge of the latest healthcare technology and trends.
• Current with all Continuing Nursing Education requirements.
• Proficient with extensive related computer applications.
• Demonstrated ability to deliver resident and patient care with minimal disruptions and obstacles.
• Demonstrated history of critical thinking and problem-solving skills.
• Excellent interpersonal and leadership skills with the ability to motivate a workforce.
• Ability to work effectively on an interprofessional team.

Embedded within the nursing department, the Assistant Director of Nursing oversees clinical development, performance improvement, and patient care progression for high- and low-volume populations with unpredictable needs. Working closely with the Director, this role coordinates orientation, continuing education, departmental scheduling, and budget input to advance patient outcomes and satisfaction in an acute care environment.

Core Functions

• Supervise and role-model the nursing process to assist staff in providing patient care appropriate to high- and low-volume patient populations with unpredictable needs.
• Verify that initial and ongoing assessments include collaboration with patients, significant others, and other healthcare providers.
• Verify that patients consistently have a documented plan of care based on assessment data, including discharge planning developed in collaboration with patients, significant others, and healthcare providers.
• Evaluate patient progression toward desired outcomes and coordinate alternative actions with staff to promote progression and overcome barriers.
• Monitor variances to expected outcomes, identify trends, and suggest changes needed to optimize patient outcomes.
• Provide leadership for the department in meeting organizational goals and objectives and monitor and report compliance with departmental policies and procedures.
• Coordinate departmental orientation, continuing education, and clinical development.
• Initiate and administer coaching and counseling for employees in collaboration with the Director.
• Assist in implementing performance improvement activities and facilitate staff participation in quality improvement education.
• Communicate customer satisfaction results and implement plans to enhance satisfaction.
• Participate in the selection and supervision of personnel, completion of performance appraisals, and maintenance of the departmental schedule.
• Maintain and document financial variances, including productivity, and provide input for the annual budget process.

Education & Experience

• Master's degree in a health-related field required.
• Registered Nurse licensed in North Carolina or a compact state.
• BLS certification from the American Red Cross or AHA Healthcare Provider.
• Certification in a clinical specialty as defined by national certification requirements.
• Two years of hire into the Assistant Director position.
• Five years of hire as an Assistant Director.
• Three or more years of nursing experience with leadership activities.

Reporting to the Director of Nursing, the Assistant Director of Nursing assists in planning, organizing, and directing day-to-day nursing services while managing monthly risk management, quality improvement, and infection control meetings and documentation. Partnering with nursing supervisors and front-line staff, this role supports staffing coverage, employee training continuity, and licensure compliance to deliver consistent nursing standards across care units.

Primary Duties

• Assist the Director of Nursing in planning, developing, organizing, implementing, evaluating, and directing the day-to-day functions of nursing services.
• Directly manage all monthly risk management, quality improvement, and infection control meetings, documentation, and in-services.
• Supervise and manage assigned staff, including performance evaluations, scheduling, orientation, training, and ongoing support, and resolve employee relations issues as needed.
• Assist the Director of Nursing in determining staffing needs and fill in as floor nurse as needed.
• Make daily rounds of nursing service departments to ensure all personnel perform work assignments in accordance with acceptable nursing standards.
• Assist in developing in-service training programs for nursing staff and ensure training meets continuing education requirements for licensure maintenance.

Skills & Qualifications

• Associate degree or higher in nursing with current RN licensure.
• One year of experience working with patients on ventilators preferred.
• Strong communication skills.
• Ability to build rapport with others.
• Self-motivated, highly organized, and detail-oriented.

Sitting at the intersection of clinical nursing leadership and resident-centered care coordination, the Assistant Director of Nursing assists in planning, coordinating, and managing the Resident Services Department under the close supervision of the Resident Services Director. Operating across staff evaluation, policy development, and orientation processes, this role builds departmental alignment with Wellness philosophy and regulatory standards in an assisted living environment.

Leadership Responsibilities

• Assist in planning, coordinating, and managing the Resident Services Department.
• Assist in the overall direction, coordination, and evaluation of services provided to residents.
• Work closely with and under supervision of the Resident Services Director in the overall operation of the department.
• Support and practice the philosophy, objectives, and standards of the Resident Services Department and participate in their revision as necessary.
• Participate in the development of policies and procedures that support Resident Services Department objectives.
• Ensure the philosophy, objectives, and standards of the Resident Services Department are incorporated into the orientation and education of personnel.
• Incorporate Wellness philosophy, standards, and objectives into the staff evaluation process.

Requirements

• Graduate of an accredited school of nursing.
• Additional certification in the nursing specialty of Geriatrics desirable.
• Current CPR certificate.
• Two years of experience in an assisted living environment desired.
• Three years of experience in a position with management and leadership responsibilities.
• Familiarity with state regulations.
• Ability to communicate effectively in written and oral form with residents, families, staff, and representatives of community and state agencies.

A key member of the nursing leadership team, the Assistant Director of Nursing supports the Director of Nursing by delivering direct resident care, monitoring documentation systems, and facilitating regulatory compliance during surveys and inspections. Collaborating across departments and with residents and families, this role builds interdepartmental relations and ensures nursing policies and standards of practice remain current with corporate and external regulatory guidelines.

Duties

• Serve as a liaison between the Director of Nursing and nursing staff.
• Participate in the development and achievement of nursing department goals and objectives, including staff development and educational programming.
• Assist in the implementation of and monitor compliance with policies, procedures, and standards of practice consistent with corporate and external regulatory guidelines.
• Collaborate with various department heads to promote positive interdepartmental relations.
• Assist in the development, implementation, and monitoring of an accurate and effective documentation system.
• Provide direct resident care as staffing patterns demand.
• Assure effective interaction with residents and families.
• Attend and participate in department and facility meetings as required.
• Assist surveyors and inspectors to facilitate regulatory compliance.
• Complete preceptor training as required.

Experience & Qualifications

• Graduate of an accredited school of nursing with current, unencumbered, active RN licensure.
• Current CPR certification.
• Minimum of three years of nursing experience in a setting serving the same age and type of resident population, with a minimum of one year of management experience preferred.
• Knowledge of local, state, and federal regulations pertaining to facility function.
• Knowledge of accreditation standards and compliance requirements.
• Excellent communication and interpersonal skills.
• Availability to work beyond normal working hours and on weekends and holidays when necessary.
• Availability for callback during emergency conditions.

Sustaining safe, regulation-compliant nursing care across all units depends on the Assistant Director of Nursing, who manages nursing services in the absence of the Director, oversees resident accident and incident reporting, and inspects nursing service areas for ongoing regulatory adherence. Based within a healthcare facility, this role leads recruitment and training of nurses and monitors nursing employee adherence to wound care, medication safeguarding, and resident care protocols.

Functions

• Manage nursing services in the absence of the Director of Nursing Services.
• Supervise nursing supervisor staff and inform them of new policies and procedures.
• Oversee resident accident and incident reporting and resident abuse investigations.
• Assist in the recruitment, retention, and training of nurses.
• Ensure legal procedures, nursing practices, and work standards are met per facility policies and procedures and all regulatory requirements.
• Maintain confidentiality of all pertinent resident and patient care information to assure patient rights are protected.
• Inspect nursing service areas and monitor practices for compliance with current applicable regulations on a regular basis.
• Make daily rounds in nursing units to ensure resident care is appropriately provided.
• Monitor and review documentation on new admissions to ensure needs are met.
• Monitor nursing employee adherence to facility policies related to wound care, meal service, safeguarding of controlled medications, and provision of resident care.

Position Requirements

• Current RN license in good standing.
• Infection Control certificate or in the process of obtaining one.
• Minimum of three to five years of experience at the nursing management level in a healthcare facility.
• Knowledge of CDC guidelines related to infection control.
• Strong leadership qualities with good judgment and conflict resolution skills.
• Excellent written and oral communication skills with the ability to plan, organize, and implement policies and procedures.
• Ability to assist in emergencies.
• Willingness to learn and take direction from senior clinical leadership.
• Ability to maintain cooperative relationships among healthcare team members by communicating information, responding to requests, building rapport, and participating in team problem-solving.

As the Assistant Director of Nursing, this role provides direct management of nursing coordinators and project management oversight across all nursing departments, operationalizing strategic visions from the Director of Nursing through departmental policy development, proactive needs analysis, and front-line change management. The nursing team relies on this work to align department-wide initiatives with company-wide strategic goals, maintain excellence in care coordination for complex older adult populations, and sustain a culture of continuous professional growth in a managed care setting.

Accountabilities

• Provide leadership and management to staff.
• Develop, implement, and evaluate policy for departments led.
• Provide project management oversight for all nursing departments.
• Assist the DON in operationalizing larger strategic visions across all nursing departments.
• Anticipate needs of front-line staff, leads, and support staff when managing change.
• Conduct proactive analysis of departmental needs by staying abreast of current nursing trends and understanding provider workflows to identify where nursing support could be beneficial.
• Promote and model continuous self-development and professional growth to maintain knowledge of healthcare trends and practices.

Knowledge Skills & Abilities

• Registered Nurse with BSN preferred, licensed in New York.
• Two to five years of progressive nursing leadership experience.
• Direct personnel management experience highly preferred.
• Previous experience and thorough understanding of managed care and care coordination practices.
• Demonstrated knowledge and experience with complex, frail older adult populations.
• Good computer skills with specific knowledge of Microsoft Office programs.
• Exceptional professional communication, relationship-building, and organizational skills.
• Excellent attention to detail.
• Ability to operationalize large conceptual projects and direct appropriate staff.
• Ability to work autonomously while skilled in interdisciplinary collaboration.

Assistant Director of Nursing owns nursing staff development, orientation, and yearly competency evaluation at both the site and department level while assuming 24-hour responsibility in the absence of the Director of Nursing. The work directly supports safe, timely patient management through collaboration with nurse coordinators and providers in an outpatient ambulatory care environment serving a chronic care population.

Activities

• Participate in the development and management of quality improvement projects, incorporating standards of care in accordance with regulatory guidelines.
• Assist the Director of Nursing in planning, developing, organizing, implementing, evaluating, and directing the day-to-day functions of nursing in accordance with current rules, regulations, and guidelines governing outpatient ambulatory care.
• Assist in hiring and monitoring nursing staff and other support staff activities.
• Identify patient action plans in collaboration with nurse coordinators and providers to ensure safe and timely management of patients.
• Serve as clinical resource person for nurse coordinators.
• Assume 24-hour responsibility in the absence of the Director of Nursing.

Education & Experience

• Baccalaureate degree in nursing or a related field required.
• Master of Science degree in nursing or a related field preferred.
• Valid Registered Professional Nurse license with current registration.
• Minimum of four years of management experience.
• Two years of experience as a Registered Professional Nurse.
• Excellent interpersonal and communication skills, written and oral.
• Effective management skills necessary to organize, direct, and evaluate patient care operations.
• Critical thinking and analytic skills necessary for problem-solving and clinical decision-making.
• Ability to apply balanced scorecard measures across customer service, financial, innovation, and performance improvement dimensions.

The Assistant Director of Nursing oversees internal audits, staff induction and training, health and safety policy implementation, and fire safety planning while covering the Director of Nursing as needed in a care home setting for older persons. Reporting to senior clinical leadership, this role develops community agency relationships and drives resident participation in community activities to maintain the highest hygiene, safety, and care standards across the home.

Operational Focus

• Conduct internal audits and follow up on results.
• Oversee initial induction, ongoing training, and development of staff.
• Encourage innovative practice.
• Ensure implementation of and adherence to company standards, procedures, and guidelines.
• Conduct regular communication meetings with all clinical staff.
• Establish rapport with external community agencies and facilitate resident participation in community activities.
• Implement health and safety policy to safeguard the safety and welfare of staff, residents, and others.
• Implement regular fire training and evacuation plans.
• Ensure hygiene and cleanliness of the home is maintained to the highest standard.
• Ensure a preventative maintenance programme is in place and implemented.
• Participate in the selection and interviewing of staff and conduct regular training needs analysis.
• Cover the Director of Nursing as needed.

Background & Experience

• Qualified Nurse with at least three years of management experience in the care of older persons in the last six years.
• Post-registration management qualification in health or a related field.
• Proven track record in healthcare clinical management.
• Excellent leadership, organisational, and communication skills.
• Sound decision-making ability and results-driven approach.
• Ability to work well and promote a team environment.
• Willingness to be flexible and adapt to organisational needs.