Director of Nursing (DON)

About Alliance Home Care

Alliance Home Care is a Minnesota-licensed home care agency providing skilled and non-skilled services to individuals in their homes and communities. Our team is dedicated to dignity, safety, and enabling clients to live independently with the support they need.

Position Summary

The Director of Nursing provides clinical and operational leadership for all nursing and aide services at Alliance Home Care. The DON is accountable for the quality, safety, and regulatory compliance of clinical care delivered to clients in their homes, including oversight of the plan-of-care process, supervision of licensed and unlicensed clinical staff, OASIS accuracy, Medicare and Medicaid billing integrity, and agency readiness for Minnesota Department of Health (MDH) surveys and CMS Conditions of Participation audits. This is a working leadership role: the DON is expected to be present in the clinical operation, mentor staff, and lead by example.

Essential Duties and Responsibilities

Clinical Leadership and Quality

• Directs and oversees all skilled nursing, LPN, and home health aide services to ensure care is delivered safely, effectively, and in accordance with physician-ordered plans of care.
• Reviews and approves plans of care; ensures OASIS assessments are accurate, complete, and locked within agency timeframes; leads the clinical review process for PDGM case-mix accuracy.
• Monitors clinical outcomes and quality indicators; develops and leads performance improvement initiatives consistent with the agency’s QAPI program (42 CFR 484.65).
• Conducts or delegates clinical record reviews to ensure documentation supports homebound status, medical necessity, skilled need, and all billed services.
• Leads infection prevention and control program; ensures staff compliance with standard precautions and OSHA Bloodborne Pathogens standard.
• Oversees the HHA supervisory visit program (42 CFR 484.80(h)) and ensures all 14-day supervisory visits and annual direct-observation visits are completed and documented on schedule.

Regulatory Compliance and Survey Readiness

• Maintains current knowledge of CMS Conditions of Participation (42 CFR 484), Minnesota home care statutes (Minn. Stat. ch. 144A), MDH home care rules, and DHS Medicaid/CFSS program requirements.
• Leads the agency’s preparation for and response to MDH home care licensing surveys and CMS certification surveys; serves as the primary clinical contact during surveys.
• Ensures all clinical personnel files meet state and federal requirements: licensure verification, background studies, competency evaluations, orientation documentation, and in-service records.
• Oversees compliance with the Minnesota Home Care Bill of Rights (Minn. Stat. 144A.44), Vulnerable Adults Act mandated reporting, and HIPAA privacy and security requirements.
• Develops, reviews, and updates clinical policies and procedures annually and in response to regulatory changes.

Staff Supervision and Development

• Hires, orients, supervises, evaluates, and when necessary disciplines or terminates clinical staff, including RNs, LPNs, and HHAs, in accordance with agency policy and applicable law.
• Conducts or oversees competency evaluations for all clinical staff before independent practice and annually thereafter.
• Provides direct clinical supervision to RNs and LPNs; ensures LPN practice remains within the Minnesota LPN scope of practice under RN supervision.
• Develops and delivers clinical in-service education; maintains in-service records meeting the 12-hour annual requirement for HHAs (42 CFR 484.80(e)) and agency standards for licensed staff.
• Mentors clinical staff and fosters a culture of continuous learning, accountability, and person-centered care.

Operational and Administrative Responsibilities

• Collaborates with the Intake Coordinator and scheduling team on start-of-care timelines, case assignments, and clinician workload management.
• Works with the billing and coding team to resolve clinical documentation issues affecting claims; serves as the clinical authority on coverage and medical necessity questions.
• Participates in leadership meetings; reports clinical quality metrics, staffing status, and compliance findings to the Administrator/CEO.
• Serves as the on-call clinical resource for complex clinical situations and urgent client needs outside of normal business hours as needed.
• Supports the agency’s marketing and growth goals by maintaining the clinical quality and reputation that drive referral source confidence.

Required Qualifications

• Current, unencumbered Registered Nurse (RN) license in the State of Minnesota.
• Minimum three (3) years of RN experience, with at least one (1) year in home health, community health, or a Medicare-certified post-acute setting.
• Demonstrated leadership or supervisory experience in a clinical setting.
• Working knowledge of Medicare home health Conditions of Participation (42 CFR 484), OASIS, and PDGM.
• Familiarity with Minnesota home care statutes (Minn. Stat. ch. 144A) and MDH home care licensing requirements.
• Current Basic Life Support (BLS) / CPR certification.
• Valid driver’s license and reliable personal vehicle with current auto insurance.
• Ability to pass a Minnesota DHS background study (Minn. Stat. ch. 245C).
• Strong written and verbal communication, critical thinking, and organizational skills.

Preferred Qualifications

• Bachelor of Science in Nursing (BSN) or higher.
• Two (2) or more years of home health management or DON experience.
• OASIS certification (COS-C) or experience leading OASIS accuracy and QA programs.
• Experience with KanTime or comparable home health EMR.
• Experience navigating MDH licensing surveys or CMS certification reviews.

Required Training (Provided or Verified by Alliance Home Care)

• Agency orientation covering the Minnesota Home Care Bill of Rights, client rights, agency policies, and regulatory framework prior to independent practice.
• Vulnerable Adults Act and maltreatment mandated reporter training.
• HIPAA privacy and security training.
• OASIS competency training and annual accuracy review.
• Annual clinical in-service and continuing education to maintain RN licensure and agency competency standards.

Physical Requirements

• Primarily office-based with regular field visits to client homes for supervisory, quality, and clinical review purposes.
• Ability to perform clinical assessments and supervisory visits in varied home environments, including bending, kneeling, and working in confined spaces.
• Ability to lift and assist clients as needed, up to 50 lbs, during supervisory or clinical visits.
• Manual dexterity for clinical procedures and EHR documentation.
• Ability to drive to client locations and referral sources throughout the service area in varying weather conditions.

What We Offer

A leadership role with real authority and real impact — the DON at Alliance Home Care shapes the clinical culture, drives quality outcomes, and is a trusted partner to the Administrator/CEO. We offer competitive compensation, a collaborative leadership team, and the support and resources to build a high-performing clinical operation. Alliance Home Care invests in its leaders with paid continuing education, leadership development, mileage reimbursement, and meaningful opportunities for professional growth.

Schedule

Alliance Home Care offers full-time, part-time, and PRN opportunities. Visit schedules and shift expectations vary by case assignment and will be reviewed during the interview process.

Benefits

Alliance Home Care is proud to invest in our team. Eligible employees receive:

• Health, dental, and vision insurance
• Paid time off (PTO) and paid holidays
• 401(k) retirement plan
• Employer-paid life and disability insurance
• Employee Assistance Program (EAP)
• Paid training and continuing education
• Mileage reimbursement
• Employee referral bonuses
• Career growth and advancement opportunities within Alliance Home Care

Benefit eligibility varies based on employment status (full-time, part-time, or PRN) and length of service.

Equal Opportunity Employer

Alliance Home Care is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees and the clients we serve. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, sexual orientation, gender identity, veteran status, or any other status protected by law.