Assistant Chief Nursing Officer

Description

The Assistant Chief Nursing Officer (ACNO) shares administrative authority and responsibility for the practice of nursing, clinical operations, and staff development within the Inpatient Rehabilitation Hospital. This role requires a dynamic leader who seamlessly transitions from high-level operational management to frontline clinical care. The ACNO is directly responsible for daily staffing models, scheduling, and clinical productivity, and will actively fill staffing gaps by carrying floor shifts and participating in the leadership on-call rotation.

Key Responsibilities

Operations, Staffing & Scheduling (Primary Focus)

• Dynamic Scheduling: Oversee the development and implementation of the master nursing schedule, ensuring safe nurse-to-patient ratios that comply with both state mandates and acuity-based staffing models.
• Frontline Execution: Actively carry floor shifts (providing direct patient care, administering medications, and leading shift huddles) during critical staffing shortages or high-acuity surges.
• On-Call Leadership: Participate in the administrative and clinical on-call rotation to troubleshoot operational issues, manage call-outs, and ensure 24/7 leadership coverage.
• Productivity Management: Monitor and adjust daily staffing levels based on midnight census and patient acuity to optimize Hours Per Patient Day (HPPD) metrics.

Clinical Leadership & Quality Assurance

• Rehab Continuity of Care: Partner with the Therapy/Physical Medicine and Rehabilitation (PM&R) teams to ensure nursing care reinforces functional independence and patient therapy goals.
• Regulatory Compliance: Ensure the nursing department complies with all Joint Commission, CARF (Commission on Accreditation of Rehabilitation Facilities), and CMS regulations specific to inpatient rehabilitation facilities (IRFs).
• Quality Metrics: Monitor and drive initiatives to reduce hospital-acquired conditions common in rehab settings, including pressure injuries, falls, and catheter-associated urinary tract infections (CAUTIs).

Talent Development & Retention

• Mentorship & Onboarding: Oversee the orientation and onboarding of new nursing staff, ensuring competencies specific to rehabilitation nursing (e.g., bowel and bladder training, transfer techniques) are met.
• Performance Management: Assist the CNO with conducting performance evaluations, providing real-time clinical coaching, and managing disciplinary actions as needed.
• Culture & Retention: Maintain high visibility on the units to foster a supportive, collaborative work environment that reduces nurse burnout and turnover.

Requirements

Qualifications & Skills

Education & Experience

• Degree: Bachelor of Science in Nursing (BSN) required; Master’s degree (MSN, MBA, or MHA) preferred.
• Licensure: Active, unrestricted Registered Nurse (RN) license in the state of operation.
• Experience: Minimum of 3–5 years of progressive nursing leadership experience (e.g., Charge Nurse, Nurse Manager, or Supervisor).
• Setting: Experience in an Inpatient Rehabilitation Facility (IRF) or acute care setting is highly preferred.

Certifications

• Required: Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS).
• Preferred: Certified Rehabilitation Registered Nurse (CRRN) designation is a major plus (or willingness to obtain within 12–18 months of hire).

Essential Skills

• Adaptability: Proven ability to pivot instantly from budget meetings and regulatory prep to delivering direct patient care on the floor.
• Problem-Solving: Expert-level conflict resolution skills, particularly regarding scheduling disputes, short-staffing crises, and emergency call-outs.
• Communication: Strong interpersonal skills to effectively collaborate with physicians, therapists, families, and floor staff.

Physical Requirements & Working Conditions

• Must be able to stand, walk, bend, and lift patients frequently during floor shifts.
• Requires flexibility to work varied shifts (days, nights, weekends) based on hospital staffing shortages and on-call needs.