Director of Nursing (DNS) – Intermediate Care Center | Full Time

Holly Thompson

Why Blue Mountain Hospital District & Grant County?

The Blue Mountain Hospital District (BMHD) is located in Grant County, Oregon, at the heart of the John Day River, in beautiful, rural, Eastern Oregon.  Our District is comprised of a Critical Access Hospital (CAH), Family & Rural Medicine Clinic, Home Health and Hospice, Emergency Medical Services, an Intermediate Care Center and all of the supporting ancillary departments necessary to care for the health and wellness of our community.

Our District spans from John Day to Prairie City, nestled in a valley surrounded by the Blue Mountains.  The Strawberry Mountain Range and John Day River Valley offers a variety of outdoor activities, from abundant hiking/mountain biking/horse riding trails, to high and low lakes and ponds.  Our area is known to be a “go to” place not just for recreation, but also for big game hunting and fishing!

Join our family-like team and settle into a lifestyle that is hard to beat!

For more information on our area, visit our Grant County Chamber of Commerce page at:

Job Summary 

The Director of Nursing Services has administrative authority, responsibility, and accountability for assuring functions and activities of the nursing services department.  DNS participates in the development of any facility policies that affect the Nursing Services department.  The DNS is directly responsible to the facility Administrator. Ensures the compliance with resident care quality standards as it relates to the care provided to all age groups. Maintains performance improvement activities within the department and participates in PI activities. Works with facility Administrator to assure competency of all nursing services personnel in areas of responsibility. Assists in formulating the budget and maintains efficient and effective departmental operations while required compliance with all state, federal, and local regulations, laws, standards and protocols. Participates in performance improvement and continuous quality improvement (CQI) activities.

Essential Functions and Responsibilities

  • Promotes the mission, vision and values of the BMHD.
  • Maintains, interprets, and adheres to facility policy and procedures.
  • Ensures the continual delivery of high quality nursing services care through implementation of evidence-based practices and standards.
  • Maintains evidence base nursing guidelines by developing, implementing and revising nursing policies and procedures.
  • Maintains nursing personnel by recruiting, selecting, orienting qualified staff.
  • Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications, attending webinars, establishing professional networks, participates in professional organizations.
  • Ensure nursing personnel remains in compliance with licensure, certifications, professional development, and regulatory standards.
  • Designs and implements performance improvement project within the nursing services that improves the quality of care and the experience for patients and families.
  • Organizes problem solving and effective communication systems for departments and serves as a connection between the ancillary department and the medical staff.
  • Acts as a resource person, interpreting, supporting and executing procedures and policies as designated by Administrator.
  • Has knowledge of and ensures that the Nursing Services Department adheres to State and Federal rules and regulations concerning delivery of resident care.
  • Maintains a Quality Assurance and Performance Improvement (QAPI) for nursing services that includes: infection control audits; safety audits; skin audits; resident care audits; environmental audits; chart audits; nutritional/weight audits; medication audits and employee competency audits. Also an Antibiotic Stewardship program and ethics committee.
    • These audits may be delegated to other Nursing Services personnel to perform.
    • The DNS is aware of facility trends and directs plan of correction of these trends.
    • Evaluates the effectiveness of the QAPI program by observing trends.
    • Attends and directs quarterly QAPI meetings, in conjunction with Administrator.
  • Ensures that all medications, treatments, and plans of care are administered as ordered in collaboration with the RN Care Manager.
  • Responsible for assisting Nursing Department and communicating with State Surveyors during annual State Survey.
  • Is in attendance during exit conference.
  • Assists administration with writing plan of correction.
  • Coordinates nursing service departmental functions and activities with the functions and activities of other departments.

Core Accountabilities 

Is informed regarding residents’ conditions, including when a significant change in residents condition warrants nursing or medical intervention.

  • Reads daily 24 hour report.
  • Meets daily with the RN Care Manager concerning resident conditions and nursing care delivery.
  • Assists RN Care Manager in assessing resident conditions and making decisions on medical interventions.
  • Evaluates nursing care delivery by making rounds on a daily basis.
  • Attends resident care planning conferences.
  • Assists RN Care Manager in coordinating provision of services with other health care providers.
  • Notifies physicians of needed visits after repeated attempts by Medical Records and RN Care Manager have failed.
  • Involves Medical Director as necessary.
  • Develops and maintains personnel policies of recruitment, orientation, in service education, evaluation and termination of Nursing Service Staff. Demonstrates leadership abilities.
  • Interviews Nursing Staff and makes decisions on hiring.
    • Reviews job descriptions with new employees.
    • Ensures employee file is complete.
  • Ensures adequate staff orientation.
  • Ensures RCM and Charge Nurse are adequately supervising staff, to ensure that all Nursing Staff perform their duties in a timely efficient professional manner.
  • Ensures all mandatory in-services are held along with other in-services needed according to facility QAPI trends.
  • Ensures adequate nursing services staffing according to State/Federal requirements.
  • Maintains a written staffing plan.
  • May delegate staffing to another qualified individual.
  • Supervises staffing plan as performed by other individuals.
  • Works as a Charge Nurse on the floor as necessary.
  • Ensures that each employee recognizes legal responsibilities and functions within scope of practice.
  • Grievance Officer
  • Performs and ensures that other nursing staff assist with performing employee performance evaluations.
  • Performs disciplinary action of nursing personnel and counsels as necessary.
  • Terminates nursing personnel when necessary.
  • Provides input to change process and supports Administrator and Care Center in process.
  • Demonstrates professional responsibility of conduct and attendance record.
  • May cover in Administrator’s absence.
  • Determines Nursing Staff’s capacity for providing nursing care for any person seeking admission to the facility.
  • Assists with taking resident intakes for admission to facility in collaboration with Social Services and Administration.
  • Assists with decisions concerning resident admission to facility in collaboration with Social Services and Administration.
    • May perform a visit to discharging facility to determine admission status.
    • Communicates all potential admissions to Resident Care Manager.
  • Maintains adequate supplies for nursing care delivery.
  • Demonstrates ability to establish priorities and organize effectively. Has excellent written and verbal communication skills.
  • Develops a nursing services budget in collaboration with the facility Administrator.
    • Remains within established budget or communicates additional needs to Administrator.
  • Keeps work area neat.
  • Establishes priorities for Nursing Department and delegates as necessary.
  • Reports all problems, needs, concerns to the Administrator.
  • Interacts with all members of the interdisciplinary team in a professional manner.
  • Interacts with resident families in a professional manner.
  • Acts as a resource person and accepts guidance from available resources.
  • Participates in the education of staff, residents and family members.


Demonstrate ability to maintain a high level of output without sacrificing quality.

  • Able to demonstrate and maintain consistent and efficient performance.
  • Able to work with small products with repetitive motion and dexterity required.
  • Ability to determine appropriate course of action in more complex situations.
  • Ability to manage multiple and simultaneous responsibilities and to prioritize scheduling of work.
  • Ability to complete work assignments accurately and in a timely manner.
  • Completes annual education requirements.

Technical Skills

Demonstrate ability to learn and maintain appropriate technical skills to effectively support the Care Center.

  • Displays a proficient understanding of leadership and management skills.
  • Displays the ability to demonstrate leadership, managerial, good interpersonal relationships and the application of sound administrative principles.
  • Ability to communicate to effectively, both oral and written through e-mail, presentations etc.
  • Displays an understanding of electronic healthcare systems.
  • Proficiency with Microsoft Google Calendar, Gmail, Excel, PowerPoint, keyboarding, and reporting.


Establish & maintain solid work relationships, through communication, cooperation, and positive interaction with all employees, staff and physicians.

  • Approachability – build rapport by making the effort to be cooperative and adaptive, put others at ease, and support co-workers.
  • Listening – practice active listening; display patience when listening to the views of others, and discuss differing opinions with an open mind.
  • Problem Solving work with others to prevent problems & find a solution when issues arise.
  • Effectively and consistently communicates administrative directives to personnel and encourages interactive departmental meetings and discussions.
  • Works with other department heads/supervisors to assure quality of facility.

Customer Service

Exhibit professional behavior while being caring and compassionate.

  • Customer Focusdedicated to meeting the expectations of the internal customer.
  • Demonstrate sensitivity, empathy, concern and respect for others. Act with the patient care in mind, gain trust and respect by building and maintaining effective relationships.
  • Maintain confidentialityin accordance with the Oregon Board of Nursing, Care Center and HIPAA regulations.
  • Represents the organization in a positive and professional manner at all times.
  • Establish and maintain cooperative working relationships with others including physicians, nurses, administrators, managers, vendors, state agencies, and other health care industry personnel.

Effective Use of Resources

Maximize the resources while minimizing waste and controlling expenses.  This includes the effective use of work time and supplies, working safely, following established work practices, and seeking ways to improve operations.

  • Improvement – recommend procedures that reduce costs and streamline operations while improving quality.
  • Maintain neat, clean and professional work area.


Self-motivated and contribute to new ideas.

  • Improvements – initiate improvements and apply new methods of working to help achieve goals.
  • Learning on the go develop an action plan when facing new problems, and be open to change.
  • Assumes responsibility for professional growth and continuing education. Is responsible for meeting own continuing education according to State law.
  • Attends outside conferences and shares information.
  • Recognizes legal responsibilities and functions within scope of practice.
  • Serves on nursing committees as appropriate.

Supervisory Responsibilities 

  • Supervises all nursing staff, RCM, RA, and Activities departments.
  • Handles all the supervisory duties for the nursing services.
  • Complete the work schedules, delegate assignments, assign tasks and evaluate job performance as well as disciplining employees who do not fulfill their job requirements or provide adequate nursing services care.
  • Set goals and standards for the nursing services and hold regular staff meetings which they provide communication and direction which leads to discussion for areas for improvement.
  • Assists with the personnel management activities of assigned areas, provides guidance to Charge Nurses on the selection, hiring, training and development of nursing staff as well as performance appraisal, documentation of deficiencies, performance recognition and disciplinary action; develops, supervises and appraises nursing staff; plans and implements disciplinary actions as needed, working with Human Resources as appropriate; makes recommendations to facility administrator regarding evaluation, promotion, transfer or discipline of nursing personnel.
  • Supervise and coordinate departmental operations and personnel in accordance with BMHD standards with those departments assigned.
  • Coordinate the monthly completion of Productivity Reports for management to include staff contract hours and statistics by department.
  • Counsel, develop work plans, identify education needs, and/or implement the disciplinary process as needed in conjunction with evaluating the staff at least annually on their performance.
  • Collaborates with the facility Administrator and Human Resources to mediate conflicts between employees and/or department management to resolve misunderstanding, facilitate communication and to promote effective working relationships (as needed).
  • Assist Human Resources to interview, hire, orient and train staff to fulfill the staffing plan and maintain a balanced, qualified staff in conjunction with developing, maintaining, and periodically updating written job descriptions for each level of nursing personnel.

Supervised By

  • Reports to the facility Administrator.

Knowledge, Skills and Abilities 

  • Maintains self-motivation and sustains a high level of momentum.
  • Able to successfully prioritize when faced with requests, demands and deadlines.
  • Knowledge of customer service concepts.
  • Must be extremely detail oriented and able to perform accurate and thorough chart reviews and record keeping.
  • Proven ability to communicate effectively, both in written and oral form.
  • Ability to communicate effectively in English, both verbally and in writing.
  • Proven ability to work as part of a team, in a fast-paced production-oriented environment.
  • Proven presentation skills.
  • Expresses excellent judgment, discretion and decision making abilities.
  • Maintains a sensitive, fair and impartial approach to dealing with employees.
  • Supports and maintains a culture of safety, quality and positive patient experience.
  • Working knowledge of relevant regulatory requirements, CMS, National Patient Safety Goals (NPSGs), and continued readiness related to healthcare or hospital standards.
  • Ability to prioritize, highly organized.
  • Experience in the care of the geriatric resident.
  • Demonstrated leadership abilities.
  • Proven ability to communicate effectively to staff, residents, and family members.

Education Requirements 


  • Bachelor of Science in Nursing Degree (BSN)
  • Must have at least six months in a nursing facility
  • Graduate of an accredited program of nursing education.
  • Must complete 30 continuing education hours pertinent to nursing administration every two years.


  • MSN preferred.  Oregon State law mandates that within nine months of employment the DNS have successfully completed six credit hours in management or supervision pertinent to long-term care or have a BSN or MSN with course work in management.

Certification/Licensure Requirements


  • Oregon RN Licensure


  • BLS Certification