Job Description

DIVISION: Community Living

REPORTS TO: Community Living Lead Nurse

SUPERVISES: 0

EXEMPTION STATUS: Exempt

The Community Registered Nurse (RN) is responsible for overseeing the medical, health, and wellness needs of individuals served within Community Living residential programs.

This role ensures the development, implementation, and ongoing monitoring of individualized health care plans, in accordance with Missouri Department of Mental Health (DMH) Division of Developmental Disabilities standards, physician orders, and best nursing practices.

The Community RN provides clinical oversight, assessment, delegation, training, and monitoring of health-related services, ensuring that all medical supports are delivered safely, accurately, and consistently across residential settings.

This role operates independently across multiple homes and is accountable for ensuring that individuals receive coordinated, person-centered, and compliant medical care that supports their overall health and quality of life.

QUALIFICATIONS:

Education & Licensure

• Active Registered Nurse (RN) license in the State of Missouri
• Bachelor’s degree in Nursing
• Current CPR/First Aid certification

Experience

• Minimum of 2 years of nursing experience
• Experience with individuals with developmental disabilities preferred
• Experience in community-based or residential settings preferred

Skills & Competencies

• Strong clinical assessment and critical thinking skills
• Knowledge of DMH/DD regulations and nursing standards
• Ability to develop and monitor individualized health care plans
• Strong organizational and documentation skills
• Ability to work independently across multiple sites
• Strong communication and training skills
• High level of accountability and attention to detail
• Strong leadership presence with an ownership mentality
• Ability to train, coach, and hold staff accountable
• Innovative problem-solver who challenges outdated practice
• High accountability and follow-through
• Ability to manage multiple priorities in a fast-paced, 24/7 environment
• Ability to lead calmly and decisively in high-pressure situations
• Proficiency in Microsoft Office and operational data management systems

Requirements

KEY RESPONSIBILITIES:

Dignity First

• Ensures all health care services are delivered with dignity, respect, and compassion
• Protects the health, safety, and rights of individuals served
• Advocates for appropriate medical care and treatment

Person-Centered Living

• Develops and maintains individualized health care plans based on each person’s medical needs
• Ensures plans reflect physician orders, diagnoses, and personal needs
• Promotes autonomy and informed decision-making in health care

Connected Community

• Coordinates with physicians, specialists, pharmacies, and external providers
• Supports integration of medical care within daily routines and environments
• Ensures continuity of care across providers and settings

Whole-Person Support

• Monitors overall health status, including physical, behavioral, and medical conditions
• Tracks trends in health indicators (weight, vitals, labs, behaviors, etc.)
• Identifies and responds to changes in condition proactively

Empowerment Through Daily Life

• Ensures staff are trained to support individuals’ health needs within daily routines
• Promotes independence in health-related skills where appropriate
• Provides education to individuals and staff

Integrity in Action

• Ensures all medical documentation is accurate, complete, and compliant with DMH standards
• Reviews physician orders, MARs, and documentation regularly for accuracy
• Maintains compliance with all regulatory, licensing, and organizational requirements

Collaborative Teamwork

• Works closely with Operations, Clinical, and Direct Support teams
• Provides guidance and training to staff on medical and health-related supports
• Participates in interdisciplinary team meetings

Consistency and Compassion

• Ensures consistent implementation of medical and health care plans across all homes
• Monitors staff compliance with delegated nursing tasks
• Provides follow-up and oversight to ensure quality and safety

OTHER RESPONSIBILITIES

CLINICAL & NURSING RESPONSIBILITIES

• Conduct face-to-face nursing assessments for individuals served
• Develop, implement, and monitor individualized health care plans in accordance with DMH standards
• Review and ensure accuracy of physician orders and medical documentation
• Monitor medication administration systems (MARs) for accuracy and compliance
• Assess effectiveness of medications and monitor for side effects
• Review and interpret lab results and ensure appropriate follow-up
• Monitor key health indicators (vitals, weight, seizures, bowel, blood sugar, etc.)
• Identify trends and implement proactive interventions

DELEGATION & STAFF OVERSIGHT

• Delegate nursing tasks in accordance with Missouri Nurse Practice Act and DMH standards
• Train and supervise staff on delegated tasks (e.g., medication administration, specialized supports)
• Ensure staff competency and ongoing compliance with delegated responsibilities
• Provide ongoing monitoring and re-evaluation of delegated tasks
• Conduct L1MA (Level 1 Medication Aide) training and oversight

QUALITY ASSURANCE & COMPLIANCE

• Conduct regular audits of medical records, MARs, and documentation
• Ensure compliance with DMH, Medicaid waiver, and licensing standards
• Monitor incident reports related to health and medical issues
• Ensure follow-up on hospitalizations, ER visits, and significant events
• Maintain readiness for audits and regulatory reviews

FAMILY & STAKEHOLDER COORDINATION

• Communicate with families regarding medical needs and updates
• Coordinate medical appointments and follow-up care
• Collaborate with external providers to ensure continuity of care
• Participate in care planning and interdisciplinary meetings

ACCOUNTABILITY & IMPACT

The Community RN is directly accountable for the health, safety, and medical compliance of all individuals served within Community Living.

This role is responsible for ensuring:

• Individualized health care plans are accurate, current, and implemented
• Medication administration systems are compliant and accurate
• Delegated nursing tasks are performed safely and correctly
• Medical documentation meets all regulatory standards
• Health concerns are identified and addressed proactively

The Community RN is expected to take ownership of medical oversight and compliance, not simply review or report concerns.

Failure to meet these expectations may result in corrective action, as errors directly impact client safety, regulatory compliance, and organizational risk.

Other Duties

• Conduct staff training and supervision of delegated tasks to staff
• Participate in on-call rotations for medical situations
• Complete all documentation, billing, and reporting requirements in accordance with BHA and regulatory guidelines
• Uphold BHA’s mission, values, and Standards of Excellences values in all work performed
• Participate in meetings, trainings, and organizational initiatives
• Support additional nursing or operational needs as assigned

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Additional Conditions and Expectations

• Employees must maintain professional conduct, sound clinical judgment, and emotional regulation at all times, including during medical or behavioral escalations.
• Employees must follow all BHA nursing standards, safety protocols, and applicable regulatory requirements, including DMH and Nurse Practice Act guidelines.
• Employees are expected to maintain situational awareness and clinical oversight within residential environments to ensure safe and effective medical care.
• Employees must be able to provide training, delegation, and monitoring of nursing tasks to staff in accordance with DMH and nursing standards.
• Continuous attentiveness is required to identify and respond to changes in individuals’ medical conditions; failure to act on health concerns may result in risk to individuals served.
• Employees must maintain confidentiality, professionalism, and respect toward all individuals served, families, and staff.
• Work hours may vary based on organizational needs, including occasional evenings, weekends, or on-call responsibilities.

BHA Community Living Core Values

• Dignity First
• Person-Centered Living
• Connected Community
• Whole-Person Support
• Empowerment Through Daily Life
• Integrity in Action
• Collaborative Teamwork
• Consistency and Compassion

Fitness for Duty / Medical Evaluation (Job-Related):
BHA may require a job-related fitness-for-duty evaluation consistent with applicable law when there is a reasonable concern that an employee may be unable to safely perform the essential functions of the role (including driving, medication administration, crisis response, and continuous supervision), or as part of return-to-work clearance following certain leaves or incidents.

ACCESS TO PHI: The employee may have access to Protected Health Information (PHI). Employees must always protect the confidentiality of all client information. This includes adhering to all BHA policies and all applicable state and federal regulations regarding Protected Health Information (PHI). Sharing, discussing, or disclosing PHI in any form—verbal, written, electronic, or visual—is strictly prohibited unless explicitly authorized and required for job duties.

EQUAL EMPLOYMENTEqual Opportunity is and shall be provided for all employees and applicants for employment based on their demonstrated ability and competence without unlawful discrimination based on their race, color, national origin, ancestry, religion, sex, pregnancy, sexual orientation, gender identity, gender expression, age, disability, protected veteran status, or any other status protected by applicable state or federal law. This policy shall not be interpreted so as to violate the legal rights of religious organizations or the recruiting rights of military organizations associated with the Armed Forces or the Department of Homeland Security of the United States of America.

ADA STATEMENT: To perform this job successfully, an individual must be able to satisfactorily perform each essential job duty. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform essential job functions.

ACCOUNTABILITY/IMPACT (Degree of answerability for actions, consequences of errors in judgment, and legal liabilities)Errors in judgment or mistakes could cost the organization loss of revenue, loss of clients, and/or negatively impact BHA’s reputation.

Starting Salary: Our compensation is competitive within the market. The starting rate for this position begins at $75,000 annually, with your final offer based on a combination of your education, relevant experience, and overall qualifications as well participation in BHA's bonus program.