Registered Nurse (RN) / Licensed Practical Nurse (LPN)
Developmental Disabilities (DD) Waiver Services
Position Summary
Goshen Community Services is seeking a compassionate, organized, and highly motivated Registered Nurse (RN) or Licensed Practical Nurse (LPN) to provide nursing oversight and clinical support for individuals receiving Developmental Disabilities (DD) Waiver services throughout Nebraska.
The Nurse is responsible for ensuring that each individual receives high-quality, person-centered healthcare in accordance with physician orders, Individual Support Plans (ISP), Nebraska DHHS regulations, Medicaid Waiver requirements, and agency policies.
This position serves as the agency's primary clinical resource by providing nursing assessments, medication oversight, staff education, quality assurance, regulatory compliance, and direct support to individuals, families, Direct Support Professionals (DSPs), Residential Managers, and Program Coordinators.
The Nurse will also conduct regular home visits, provide medication aide training, monitor health outcomes, and ensure all healthcare documentation remains accurate and compliant.
Key Responsibilities
Health Assessments & Clinical Oversight
- Conduct initial nursing assessments for all newly admitted individuals.
- Perform ongoing nursing evaluations and reassessments.
- Develop individualized nursing recommendations.
- Monitor chronic medical conditions and identify changes in health status.
- Review physician orders and ensure implementation.
- Coordinate preventative healthcare services.
- Monitor nutrition, hydration, skin integrity, mobility, and overall wellness.
- Develop individualized healthcare plans when appropriate.
Monthly Home & Group Home Visits
- Conduct monthly nursing visits to every assigned group home and supported living residence.
- Assess each individual's physical and mental health status.
- Review medication administration practices.
- Inspect medication storage and documentation.
- Evaluate infection prevention practices.
- Ensure emergency medical information is current.
- Review adaptive equipment for proper use and safety.
- Observe staff performance while administering medications.
- Provide immediate coaching when deficiencies are identified.
- Submit written visit reports with recommendations and follow-up actions.
Medication Management & Oversight
- Oversee all medication administration throughout the agency.
- Ensure compliance with Nebraska DHHS regulations and agency policies.
- Review Medication Administration Records (MARs) for accuracy.
- Investigate medication errors and implement corrective action plans.
- Maintain medication storage compliance.
- Monitor controlled substances and Schedule II medications.
- Verify psychotropic medication monitoring requirements.
- Review physician medication changes.
- Coordinate pharmacy communications.
- Monitor medication side effects and effectiveness.
- Ensure medication destruction procedures are properly followed.
- Review medication expiration dates during monthly visits.
Medication Aide Training & Staff Education
- Conduct initial Medication Aide training for new employees.
- Provide annual Medication Aide refresher training.
- Perform medication competency evaluations.
- Observe medication passes and complete competency validations.
- Train employees on:
- Medication Administration
- Infection Control
- Universal Precautions
- Bloodborne Pathogens
- Diabetes Management
- Seizure Disorders
- CPR & First Aid
- Emergency Medical Procedures
- Documentation Requirements
- Medication Error Prevention
- Medication Storage
- Health Monitoring
- Neb. DHHS Nursing Regulations
- Develop educational materials and in-service training programs.
- Provide one-on-one coaching for employees needing additional support.
Individual Healthcare Coordination
- Coordinate medical appointments.
- Review physician recommendations.
- Follow up on specialist referrals.
- Communicate with physicians, hospitals, pharmacies, therapists, and guardians.
- Attend ISP meetings and interdisciplinary team meetings.
- Provide nursing recommendations during service planning.
- Coordinate laboratory work and follow-up testing.
- Ensure continuity of care after hospitalizations.
Documentation & Regulatory Compliance
- Maintain complete and accurate nursing records.
- Ensure all documentation complies with:
- Nebraska DHHS regulations
- Medicaid Waiver requirements
- CMS guidelines
- Agency policies
- Review medical documentation for completeness.
- Complete nursing notes following each visit.
- Maintain nursing assessment records.
- Monitor documentation compliance.
- Assist during internal and external audits.
- Prepare reports requested by regulatory agencies.
Quality Assurance
- Conduct monthly quality assurance reviews.
- Audit Medication Administration Records (MARs).
- Audit physician orders.
- Review health tracking documentation.
- Ensure implementation of physician recommendations.
- Monitor compliance with ISP health objectives.
- Identify trends and recommend improvements.
- Assist leadership with corrective action plans.
Emergency Response
- Respond to medical emergencies when needed.
- Provide nursing guidance during emergencies.
- Develop emergency healthcare plans.
- Train staff on emergency procedures.
- Review incident reports involving medical issues.
- Follow up on hospitalizations and emergency room visits.
Essential Functions
- Perform nursing assessments.
- Conduct monthly home and group home visits.
- Coordinate healthcare services.
- Provide Medication Aide training.
- Review MARs and medication documentation.
- Monitor psychotropic medications.
- Observe medication administration.
- Ensure medication compliance.
- Attend ISP meetings.
- Provide staff coaching.
- Maintain confidentiality.
- Assist during surveys and licensing inspections.
- Participate in agency committees.
- Support continuous quality improvement initiatives.
- Other duties as assigned.
Additional Responsibilities
Intake Responsibilities
- Complete initial nursing assessment.
- Obtain medication lists.
- Verify pharmacy information.
- Review physician orders.
- Confirm allergies.
- Verify immunization records.
- Coordinate medication delivery.
- Review hospital discharge instructions.
- Ensure medication side-effect tracking is established.
- Confirm required health monitoring protocols.
Routine Nursing Responsibilities
Daily
- Review medication concerns.
- Respond to health-related questions.
- Follow up on physician orders.
- Review medication errors.
- Provide clinical consultation to staff.
Weekly
- Review Therap "To Do" items.
- Review incident reports.
- Monitor new admissions.
- Follow up on hospital discharges.
Monthly
- Visit every assigned group home and supported living residence.
- Conduct medication room inspections.
- Audit Medication Administration Records.
- Review adaptive equipment.
- Inspect medication storage.
- Review physician orders.
- Complete nursing quality assurance audits.
- Observe medication administration.
- Meet with Residential Managers regarding health concerns.
- Review psychotropic medication tracking.
- Review seizure tracking, bowel protocols, diabetes logs, weight monitoring, and other required clinical documentation.
Quarterly
- Participate in quality assurance meetings.
- Review health outcome trends.
- Update nursing education materials.
- Conduct staff competency evaluations.
- Review infection control practices.
Annually
- Complete annual nursing assessments.
- Conduct annual Medication Aide competency evaluations.
- Assist with Individual Support Plan updates.
- Review agency nursing policies.
- Participate in annual state compliance reviews.
Qualifications
Education
- Current Nebraska Registered Nurse (RN) License or
- Current Nebraska Licensed Practical Nurse (LPN) License in good standing.
Bachelor of Science in Nursing (BSN) preferred but not required.
Experience
- Minimum 2 years of nursing experience preferred.
- Experience working with individuals with developmental disabilities is highly preferred.
- Experience with Nebraska Medicaid DD Waiver Services preferred.
- Experience in community-based healthcare preferred.
Requirements
- Active Nebraska RN or LPN license.
- Valid driver's license.
- Reliable transportation with proof of insurance.
- Ability to travel between agency locations and residential homes.
- Successful completion of all state and federal background checks.
- CPR and First Aid Certification (or ability to obtain).
- Ability to lift up to 70 pounds when necessary.
- Strong organizational and documentation skills.
Our Mission
Empowering Lives. Building Futures.
If you're passionate about making a lasting difference in the lives of individuals with developmental disabilities while serving as a clinical leader within a growing organization, we'd love to have you join the Goshen Community Services family.
