Clinical & Residential Services Director

Key Responsibilities and Duties

Statewide Residential & Clinical Leadership (Rule 115/116 Integration)

• Provide statewide leadership and oversight of residential and clinical services to ensure consistent, compliant, and person-centered support.
• EnsureRule 115 residential standards andRule 116 clinical/nursing standards are fully integrated into daily program operations.
• Support Area Managers, Residential Managers, and Team Leads in managing complex residential, medical, and behavioral situations.
• Establish statewide expectations for service delivery, documentation, staffing patterns, and home operations.

Rule 115 Application Oversight & Leadership Structure Accountability

• Serve as the statewide authority forRule 115 interpretation, implementation, and enforcement across all programs.
• Define, train, and monitor thespecific Rule 115 responsibilities of each leadership role, ensuring consistent application statewide.

Area Managers

• Ensure weekly home visits and operational oversight of assigned homes are completed and documented.
• Monitor implementation plans, staffing, medical follow-through, and daily service delivery for Rule 115 compliance.
• Verify house documentation systems (drills, logs, incident reporting, shift notes, etc.) are maintained accurately and on schedule.
• Provide coaching, corrective direction, and follow-up to Managers and DSPs tied to Rule 115 findings.

Residential Managers

• Oversee multi-home program compliance, audits, and individualized file accuracy.
• Ensure quarterly case file reviews, implementation plan updates, and support team participation meet Rule 115 expectations.
• Track Medicaid-waiver documentation standards and ensure required submissions are timely and complete.
• Coordinate with Area Managers to address systemic compliance gaps and service concerns.

Team Leads

• Maintain daily Rule 115 compliance at the home level including staffing coverage, documentation completion, and implementation of resident supports.
• Ensure all house binders, logs, and resident files are updated, organized, and audit-ready.
• Supervise DSP performance and ensure person-centered supports are delivered consistently.
• Ensure leadership teams use standardized tracking tools for Rule 115 compliance and performance monitoring.
• Hold leaders accountable for completion of corrective actions tied to Rule 115 audits, incident trends, and DHS-DDD correspondence.
• Lead statewide Rule 115 refresher training and competency checks for all supervisory roles.

Rule 115 Compliance & Residential Program Oversight

• Ensure statewide compliance withRule 115, Medicaid Waiver requirements, and DHS-DDD directives.
• Oversee systems for development, implementation, and monitoring of individual implementation plans and service outcomes.
• Ensure support team meeting participation and follow-through on identified resident risks, goals, and service modifications.
• Ensure quarterly and annual residential audits are completed and corrective actions implemented.
• Coordinate with QA/Compliance to reviewmonthly random client file reviews for Rule 115 and ensure timely corrections and retraining for staff.
• Monitor incident trends, environmental safety issues, and program risks; develop statewide mitigation plans.

House Documentation & Operational Standards

• Ensure oversight for all homes maintaining complete, accurate, and current house documentation, including:
• Fire, tornado, evacuation, and other emergency drills
• Water temperature logs
• Refrigerator/freezer temperature logs
• Medication Count Sheets and MAR/TAR alignment (with nursing oversight)
• Shift notes, progress notes, and incident documentation
• Vehicle logs and safety checks (if applicable)
• Create, standardize, and update statewide templates and tracking tools to improve documentation quality and consistency.
• Train residential leaders on documentation timelines, standards, and compliance expectations.

Clinical Services & Rule 116 Oversight

• Provide clinical direction and oversight to nursing staff and clinical contractors statewide.
• Ensure statewide compliance with Rule 116 and clinical Medicaid Waiver requirements.
• Oversee clinical documentation systems (health summaries, nursing notes, physician orders, medication reviews, treatment plans).
• Partner with QA/Compliance to reviewmonthly random clinical file reviews for Rule 116 and drive corrective follow-up with staff.
• Review clinical incidents, medication errors, adverse events, and hospitalizations; implement systemic improvements.

Medical Coordination & Appointment Management

• Oversee statewide systems for scheduling, tracking, and follow-through on routine, specialty, and emergency medical appointments.
• Personally transport and/or accompany individuals to appointments when needed for continuity, advocacy, or crisis support.
• Ensure visit results, physician orders, and recommendations are communicated to teams and implemented accurately.
• Coordinate transitions of care after hospitalizations or major medical events.

Benefits, Medicaid & Social Security Coordination

• Ensure statewide completion and tracking ofMedicaid redeterminations, including timelines, paperwork accuracy, and documentation storage.
• Oversee coordination ofSocial Security appointments and benefit setup, renewals, representative payee needs, and follow-through.
• Audit eligibility systems to prevent gaps in benefits and ensure uninterrupted funding/support.
• Collaborate with guardians, ISC/case managers, and funding entities statewide regarding eligibility issues.

Staff Supervision, Development & Workforce Systems

• Provide supervision, coaching, and performance oversight for residential and nursing leadership staff (direct reports may include Area Managers, Residential Managers, Nurses, or Case Managers.
• Ensure recruitment, onboarding, and retention systems support high-quality residential and clinical services.
• Oversee statewide staff compliance systems, including:
• Staff folders
• Annual background checks
• DSP Registry enrollment/updates
• Mandated training completion

Quality Improvement, Corrective Action & Licensing Readiness

• Lead statewide continuous quality improvement based on audits, trend data, incidents, and resident outcomes.
• Ensure all programs remain survey-ready and support preparation for licensing visits, Medicaid Waiver reviews, and compliance investigations.
• Produce statewide performance and compliance reports for executive leadership.

External & Community Liaison

• Serve as a statewide liaison to families/guardians, contracted providers, medical systems, and DHS-DDD regarding residential or clinical concerns.
• Participate in external meetings, state trainings, and regulatory updates; disseminate changes to teams and update policy accordingly.
• Strengthen community partnerships that enhance resident health, safety, inclusion, and outcomes.

Qualifications

• Bachelor’s Degree in Human Services, Social Work, Business Administration, or a related field. Advanced degree a plus.
• Minimum5 years experience in clinical/nursing and/or residential services for individuals with developmental disabilities, including2–3 years in leadership.
• Strong working knowledge ofRule 115, Rule 116, Medicaid Waiver requirements, and DHS-DDD standards.
• Demonstrated experience overseeing multi-site programs, audits, staff development, and compliance systems.
• High competence in documentation review, risk management, corrective action planning, and continuous improvement.
• Excellent organizational, analytical, training, and communication skills.
• Ability to travel statewide routinely and respond to urgent program or clinical needs.
• Proficiency in Google Suite and electronic documentation/clinical systems.
• Valid driver’s license and reliable transportation.
• Must pass required background checks and regulatory screenings.

Core Competencies

• Integrated residential + clinical leadership
• Rule 115/116 regulatory expertise and practical application
• Multi-site program management
• Documentation and audit readiness
• Medical and benefits coordination
• Staff coaching, training, and accountability
• Risk mitigation and crisis response
• Data-driven quality improvement
• Strong stakeholder communication