CARN Director

Position Summary
The Nursing Director (ND) provides oversight, leadership, and strategic direction for the Nursing
Team. The ND works in close collaboration with the Nursing Manager (NM) to ensure
high-quality nursing services, regulatory compliance, and consistent support of clients and staff.
This role is responsible for optimizing nursing operations, managing authorization processes,
maintaining educational standards, and supporting direct care teams in promoting optimum
client health.

Core Responsibilities
Leadership & Team Oversight
● Work in conjunction with the Nursing Manager (NM) to oversee day-to-day operations of
the Client Advocate RN (CARN) team.
● Ensure proper use, allocation, and optimization of nursing hours for each client.
● Maintain availability and reasonable response time for all staff at House Manager (HM)
level and above.
● Attend Management and Leadership meetings as the Nursing Team (NT) representative;
identify nursing-related challenges and develop effective solutions.
● Practice within the RN scope of practice in accordance with BRN requirements to
support client health.
Authorization Management (117s)
● Audit 117 authorizations to ensure all clients have current authorizations uploaded in
QSP.
● Notify the Operations Manager (OM) of clients whose 117 authorization expires within 3
months or sooner.
● Ensure correct use of 117 hours according to CEO direction.

● Perform the Services and Justification Assessment (SAJA) for clients with FNRC 117
authorizations and submit to the CEO.
● Follow up after each SAJA to confirm the Purchase of Services (POS) has been
obtained.
● Perform annual assessments for clients with 117 authorizations and submit to the CEO
prior to expiration.
● Maintain and delegate the monthly check-in schedule for all clients with 117
authorizations.

Documentation & Quality Assurance
● Develop and ensure adherence to Minimum Documentation Standards (MDS) for client
interactions.
● Review and monitor GER entries; develop SOPs on:
○ Routing GERs to primary RNs for follow-up
○ Developing education related to identified events
○ Communicating with staff regarding incident trends or required practices
● Review medical clients' daily service notes (covered primarily by the assigned RN).
● Audit RN hours submitted; confirm RN-to-client attachment in QSP and proper billing
under 117 RN or general nurse unless otherwise directed.
Education & Collaboration
● In collaboration with the Nursing Team (ND, NM, CARNs), maintain and expand the
team education file.
● Develop and coordinate educational materials responsive to client needs, GER trends,
and staff skill development.
● Maintain and strengthen a collaborative relationship with the FNRC RN to maximize
services and client support within the CS RN role.

Regular Tasks & Cadence

Weekly

● Review and respond to:
○ Email
○ GERs (Home → General Event Report → search last 30 days)
○ Discord communication
○ Google Chats
● Review medical clients’ daily service notes (as needed).
● Perform timecard and 117 hour adjustments every Sunday after 0001; send text
notification.
● Submit final supervisor signature on RN timecards by 1700 Tuesdays.
Bi-Monthly
● Conduct RN project meetings with CARNs:
○ Prepare agenda
○ Ensure time-efficient structure
○ Maintain minutes or recordkeeping
○ Identify opportunities and assign follow-up tasks

Monthly
● Review primary RN visit notes and any additional visit documentation.