10.07.02.20

.20 Nursing Services — Director of Nursing.

A. Director of Nursing. The nursing home shall provide for an organized nursing service, under the direction of a full-time registered nurse.

B. Termination of Services of Director of Nursing.

(1) If the nursing home terminates the services of the director of nursing, the nursing home immediately shall notify the Department of the termination.

(2) The name and license number of the replacement director of nursing shall be supplied to the Department as soon as employment begins.

(3) A copy of the agreement between the nursing home and the replacement shall be sent to the Department.

C. Director of Nursing’s Vacancy Exceeding 30 Days. If the position of director of nursing remains vacant for a period exceeding 30 days, the nursing home’s license may be revoked unless the administrator and the governing body are able to demonstrate that they have made every effort to obtain a replacement.

D. Relief for Director of Nursing.

(1) When the director of nursing is absent, the individual shall designate an experienced, qualified registered nurse to direct the nursing service.

(2) In a nursing home in which the director of nursing serves as relief for the administrator, the director of nursing shall designate a specific registered nurse who shall be in charge of the nursing service while the director of nursing covers for the administrator.

E. Responsibilities of the Director of Nursing. The responsibilities of the director of nursing shall include:

(1) Assisting in the development and updating of statements of nursing philosophy and objectives to define the type of nursing care the nursing home shall provide;

(2) Preparation of written job descriptions for nursing service personnel;

(3) Planning to meet the total nursing needs of residents to be met and recommending the assignment of a sufficient number of supervisory and support personnel for each tour of duty;

(4) Development and maintenance of nursing service policies and procedures to implement the program of care;

(5) Participation in the coordination of resident services through appropriate staff committee meetings on issues relating to:

(a) Pharmacy;

(b) Infection control;

(c) Resident care policies;

(d) Quality assurance programs; and

(e) Departmental meetings;

(6) Cooperation with administration in planning the orientation program and the staff development program to upgrade the competency of personnel;

(7) Ensuring that nursing personnel understand the philosophy and meet the objectives;

(8) Participation in planning and budgeting for nursing services;

(9) Establishment of a procedure to ensure that nursing service personnel, including private duty nurses, have valid and current Maryland licenses;

(10) Execution of resident care policies unless delegated to the principal physician or medical director;

(11) Participation in the selection of prospective admissions to ensure that the nursing home’s staff is capable of meeting the needs of all residents admitted;

(12) Coordination of the interdisciplinary resident care management efforts; and

(13) Supervision of certified medicine aides to ensure that the aides act within the limitations and restrictions placed on them.

F. Delegation of Responsibilities. The director of nursing shall make clear any authority delegated to another staff member.

G. Daily Rounds — Director of Nursing.

(1) Although daily rounds are primarily the responsibility of the charge nurse or nurses, the director or assistant director of nursing shall periodically make clinical rounds to nursing units, randomly reviewing clinical records, medication orders, resident care plans, and staff assignments and visiting residents.

(2) Upon request, the director or assistant director of nursing may accompany physicians visiting residents.

H. Director of Nursing’s Continuing Education. The director of nursing shall assume responsibility for maintaining professional competence of staff through their participation in education programs.