RN Clinical Supervisor
Posted Updated
Description
Are you looking for a career where the work you do truly matters — where you can make a meaningful difference in people’s lives every day?
Search no further.Why You’ll Love Working With Us!
We believe that when we take care of our team, they can provide the best care to our patients — that’s why we invest in your well-being, growth, and success: Your happiness is our happiness — we offer the following benefits for full-time positions:
- Dynamic, team-oriented work environment
- Strong, supportive company culture
- Growth and development opportunities
- Flexible schedules
- Medical, dental, and vision insurance
- Mileage reimbursement at current federal rate
- Company vehicle when eligible
- PTO, paid holidays, and sick days
- 401(k)
- And more!
Compassionate Care currently has six office locations (Fresno, Visalia, Modesto, Merced, San Luis Obispo, and Bakersfield) and serves ten counties in California (Stanislaus, San Joaquin, Merced, Mariposa, Madera, Fresno, Kings, Tulare, Kern, and San Luis Obispo). - and we continue to grow, creating even more opportunities for our team to grow with us.We are grounded in a culture of respect, compassion, and clinical excellence, recognizing that our employees are the heart of everything we do. Our team stays because they feel supported, valued, and fulfilled by the meaningful impact they make in our patients’ lives every day.We are seeking career-driven professionals who want stability, growth, and advancement based on merit and performance. Our diverse team reflects the communities we serve and shares a strong commitment to delivering exceptional care with heart.Join a team where your work is valued, your growth is supported, and your impact is felt every day.
We are currently seeking to fill the RN Clinical Supervisor position in Tulare County and surrounding territories.
Position Summary
Position Summary
Serves as case manager for every patient seen by the nursing staff they supervise. The role exercises ongoing audit and oversight of those patients from admission through discharge. It holds approval authority over any change to the visit schedule or plan of care, and it is accountable for each patient progressing toward discharge goals and being discharged when goals are met or skilled need ends. Once the QA/UR point-of-care call establishes the plan of care, this role owns it.
SURCH Protocol Responsibilities
- Case manager of record: Holds overall responsibility for the plan of care for every patient on supervised caseloads, including coordination across disciplines (§484.60(d)).
- Approves missed visits: Reviews each missed visit for clinical impact and reschedules/no missed visits. Confirms the physician or allowed practitioner is notified and the reason is documented. Approves or directs a make-up visit within the ordered frequency.
- Approves visit moves: Approves rescheduling outside the ordered frequency window. Confirms the move does not drop the patient below the ordered frequency or create a gap in a time-sensitive treatment (e.g., wound care, IV/CVAD, injections).
- Approves frequency changes, increases and decreases: Validates the clinical rationale against the current assessment and goals. Confirms the order is obtained from the physician or allowed practitioner before the new frequency takes effect (§484.60(b) to (c)).
- Prior Approval Form: Reviews every clinician request submitted through the HHSM Prior Approval Form: frequency requested, reason, whether documentation supports it, and visits completed to date. Approves or denies on clinical need and documented support, and records the decision in the Compassionate Comments field.
- Approves care-plan changes: Approves new or discontinued interventions, goals, and disciplines. Confirms orders are obtained and the change is communicated to every discipline on the case.
- Progress-to-discharge oversight: Reviews each patient's movement toward measurable discharge goals at a set interval (see Performance Measures). Intervenes when progress stalls with a joint visit, a care-plan revision, or a case conference.
- Discharge when appropriate: Approves discharge when goals are met, skilled need ends, or another discharge criterion applies (§484.50(d)). Prevents both premature discharge and continuation without skilled need.
- Discharge-Stabilization Tracking: Maintains the HHSM Discharge-Stabilization tracker for assigned patients (MRN, SOC date, payer, DC date, clinicians, comments). Uses it to keep stabilized patients moving to a timely, appropriate discharge.
- Escalation point for documentation: Receives LVN Five-Element Review escalations when a clinician's deficiencies persist after return for correction. Owns the coaching and corrective action from that point.
- 5E report by manager: The HHSM 5 Elements report rolls up audit results by Manager Name, which is this supervisor. Reviews the report for assigned clinicians at least weekly and acts on any element trending noncompliant.
Core Responsibilities
- Ongoing audit of supervised caseloads: Includes routine chart review, care-coordination documentation, and interdisciplinary communication.
- LVN supervisory visits and competency validation: Per agency schedule and California scope requirements.
- Timeliness oversight: SOC/ROC within 48 hours of referral or return home.
- Pop-up and joint visits: Direct observation of practice, the only check that reviews care rather than documentation.
- QAPI participation: Brings case-management trend data (missed visits, frequency changes, length of stay, discharge outcomes) to the QAPI committee.
- Player-coach caseload: Carries a limited caseload when staffing requires; target set by the DPCS.
Leadership, Accountability and Operational Duties
- Policy and procedure adherence: Follows, and enforces, every policy and procedure established by the agency.
- Availability: Available at all times during regular business hours. Serves on the on-call rotation as directed by the DPCS.
- Mandatory meetings: Attends all required leadership, clinical, and case-conference meetings.
- QAPI: Attends and actively participates in the ongoing QAPI program. Brings data, root causes, and performance-improvement actions for their area (§484.65).
- Weekly report to DPCS: Reports at least weekly with status updates for their area. The report covers caseload and census, staffing gaps, approvals pending, patients not progressing, past-due items, QA box status, and staff accountability actions.
- Staffing: Monitors staffing needs in their area continuously. Flags gaps to the DPCS and Scheduling before they cause missed visits or delayed SOCs.
- Training new staff: Assists with orientation, field preceptorship, and competency validation for new staff, including training to the SURCH standard.
- Quality across all staff types: Maintains quality standards across every discipline and employment type: full-time, part-time, per diem, and contracted.
- HHSM SURCH tracking tools: Works the HHSM tools daily and keeps them current: Prior Approval Form decisions, Discharge-Stabilization Tracking, the SOC Tracker for new frequencies, and the 5 Elements report for assigned clinicians. Entries must be up to date by the end of each business day.
- Past-due report and QA box: Monitors daily and helps clear items so documentation, OASIS, and orders never bottleneck billing. Escalates items that stall.
- Staff accountability: Holds all staff accountable for patient care, documentation, assignments, and adherence to policy and procedure. Addresses failures through documented coaching and progressive corrective action, in partnership with HR
Leading by Example
Supervisors are held to every standard they enforce. They are expected to model the compliance, documentation quality, timeliness, and work ethic expected of their staff. A supervisor's own documentation, policy adherence, and tracking currency are reviewed as part of their performance evaluation.
Decision Authority and Escalation
- Approves: Missed visits, visit moves, frequency increases and decreases, care-plan changes, and discharges for assigned patients. All such changes still require the corresponding physician or allowed-practitioner order.
- Initiates corrective action: Starts documented coaching and progressive corrective action for staff who fail to meet patient-care, documentation, assignment, or policy expectations. Formal discipline (written warning and beyond) is issued with HR. For contracted clinicians, it is handled under the terms of their agreement.
- Decides: Coaching and re-education for clinicians escalated by the LVN team; joint-visit scheduling.
- Escalates to ADON/DPCS: Denied changes the clinician disputes; patients not progressing despite intervention; repeat non-compliance after a written improvement plan; suspected falsified or copied documentation. Escalates patient-safety, abuse, or neglect concerns immediately.
Qualifications
- Active, unrestricted California RN license
- Minimum 3 years home health experience, including OASIS-based SOC/ROC assessments and case management
- Minimum 1 year in a supervisory, charge, or clinical-lead role
- Current BLS; valid CA driver's license and auto insurance
Key Competencies
- Case management across disciplines and payers
- Medicare home health coverage and discharge criteria (homebound, skilled need, MBPM Ch. 7)
- Decisive, documented approvals and denials
- Direct, respectful corrective conversations
- Leads by example: models the compliance and work ethic required of staff
- Consistent, documented accountability: the same standard for every staff and employment type
Performance Measures
- Missed visits approved with MD notification documented: 100%
- Frequency or care-plan changes with order obtained before effective date: 100%
- Visit moves approved within the same business day: 95% or more
- Patients with a documented progress-to-goal review each period: 100% (interval set by the DPCS, e.g., every 14 days and at recert)
- Discharge within 2 visits of goals met or skilled need ending: agency target; trend reported monthly
- Escalated documentation issues resolved: within 5 business days of LVN escalation
- Weekly status report to DPCS: 100% of weeks, submitted on schedule
- HHSM SURCH tracking tools current: updated daily; 100% current at end of business day
- Prior Approval Form requests decided: same business day; decision and rationale recorded
- Assigned clinicians 100%-compliant on 5E audit: rising monthly toward 95% or more
- Past-due report and QA box items for assigned staff: no item ages past agency threshold; zero billing holds attributable to the area
- Mandatory meeting and QAPI attendance: 100% (excused absences only)
- On-call rotation coverage: 100% of assigned shifts
- New-staff training and competency sign-offs: completed within orientation timeline
Regulatory anchors: 42 CFR §484.60 (care planning, coordination, orders), §484.50(d) (discharge), §484.105(c) (clinical manager), §484.110 (clinical records); MBPM Ch. 7 §30, §40.1.1; CA B&P Code §2725 / §2860.5; Title 22 Div. 5 Ch. 6.
Physical Requirements
This position requires the ability to perform essential functions safely and effectively, with or without reasonable accommodation, as provided under the Americans with Disabilities Act (ADA) and applicable California law. These requirements include, but are not limited to:
- Ability to lift, push, pull, and/or carry up to 50 pounds on a regular basis.
- Ability to stand, walk, bend, kneel, sit, and reach for extended periods of time as well as talk and hear.
- Ability to safely assist with patient mobility, transfers, and personal care needs.
- Ability to drive and travel between patient homes, facilities, or other care locations as needed.
- Specific vision abilities required by this job include close vision, distance vision, peripheral vision, and ability to adjust focus.
These physical requirements are necessary for the safe and effective delivery of care in our professional settings. Employees must be able to meet these requirements in order to perform the essential functions of the role.
Compassionate Care was established in 2003 in Fresno County and has grown into one of California’s most trusted providers of Home Health, Hospice, and In-Home Care services. We are honored to bring compassionate, high-quality care that offers comfort, dignity, and support to the patients and families we serve.Our team of experienced professionals provides medical, comfort, rehabilitative, and personal care with clinical excellence and genuine compassion. Guided by strong training and a deep heart for service, we are committed to making a meaningful difference in every home we enter.
Join our team and help us make a difference every day—in every patient, every home, and every heart.
Compassionate Care was established in 2003 in Fresno County and has grown into one of California’s most trusted providers of Home Health, Hospice, and In-Home Care services. We are honored to bring compassionate, high-quality care that offers comfort, dignity, and support to the patients and families we serve.Our team of experienced professionals provides medical, comfort, rehabilitative, and personal care with clinical excellence and genuine compassion. Guided by strong training and a deep heart for service, we are committed to making a meaningful difference in every home we enter.
Join our team and help us make a difference every day—in every patient, every home, and every heart.
CompassionateCare.com