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Job description
We are a family-owned home health agency in San Antonio with over 30 years of experience, and we are looking for a Director of Nursing who wants to lead a clinical team the right way — with real authority, real support, and an agency that has its house in order.
This is not a turnaround job. You are not walking into a mess.
We have two consecutive deficiency-free state surveys, patient satisfaction scores of 93% against a Texas average of 63%, and a physician referral network built over three decades in this community. You are inheriting a functioning agency with an experienced office team — and the room to make it even better.
Why this DON job is different
Most DON roles ask one person to be everything: clinician, compliance officer, coder, biller, scheduler, and HR. That is why most DONs burn out.
Here, you have a team around you:
A Director of Operations who owns billing, authorizations, and day-to-day operations
A QA nurse with 20 years at this agency who handles chart review and OASIS quality
Outsourced coding and QA support so you are not personally coding every chart
A dedicated intake and scheduling coordinator
An alternate supervising nurse for coverage
A modern EMR (WellSky) with mobile point-of-care charting
Your job is clinical leadership — not doing everyone else's job at 9 p.m.
We invest in technology, and you'll actually feel it
We run on WellSky SkySense, and we're rolling out AI documentation tools to our field team — including ambient AI that helps draft visit notes. We're one of the first agencies in San Antonio putting this in our nurses' hands.
Behind the scenes, we also use AI-assisted chart review and audit-defense tools to catch documentation gaps before they become denials or survey findings. That means you're not personally reading 40 charts on a Saturday to find the one problem.
If you've spent years at agencies running on outdated software and manual chart audits, this will be a different experience. We'd rather spend money on better tools than burn out good nurses.
What you will own
Clinical oversight of all patient care services and personnel under the Medicare Conditions of Participation
Plan of care review and approval, coordination of care, and case conferences
Supervision and development of field RNs and LVNs
OASIS accuracy, timely transmission, and outcome improvement
QAPI program leadership
Survey readiness and regulatory compliance (Medicare CoPs, Texas HCSSA)
Partnering with the Administrator and Director of Operations on growth and quality strategy
The kind of leader we are looking for
We are direct about this, because it matters more to us than anything else on your resume:
We are looking for a nurse leader who develops people, not one who corrects them.
Our field staff are experienced professionals. The right person for this role gives clear expectations, coaches in private, gives credit in public, and knows the difference between holding a standard and making someone feel small. If a nurse makes a documentation error, we want them taught — not embarrassed.
You will have full authority to set clinical standards here. We will back you up. In exchange, we expect the people who work under you to want to keep working here.
If you are clinically strong and people genuinely like working for you, you are exactly who we are looking for — and you already know how rare that combination is.
What we're looking for
Active Texas RN license (BSN preferred)
Home health experience required — Medicare-certified home health specifically
Prior DON, Assistant DON, Clinical Manager, or clinical supervisory experience
Working knowledge of the Medicare Home Health Conditions of Participation
OASIS-E competency
Experience with QAPI, survey preparation, or ADR/audit response
Comfort with EMR systems — WellSky experience is a plus but not required
Bilingual English/Spanish is a plus
Reliable transportation and current auto insurance
Current CPR certification
Compensation and schedule
Salary: $(85,000–95,000) annually, depending on experience
Additional per-visit compensation for any field visits you choose to make
Full-time, Monday–Friday, in-office
Paid time off
Paid holidays
Why nurses stay here
Family-owned and family-run — you deal directly with the owners, not a corporate region manager
30+ years in San Antonio home health with a clean survey record
A small, capable office team that actually communicates
Real decision-making authority over clinical practice
Stability — we have been here since 1996 and we are not going anywhere
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Worksite address
san antonio, TX, 78208, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.