How to Hire a Director of Nursing (DON)
The federal bar for this role is a single RN license — but the gap between that floor and what a facility actually needs is where most hiring decisions live. Here is what CMS requires, what the role owns, and a job description you can post today.
Quick answer
Under 42 CFR §483.35, a nursing home must designate a Registered Nurse as Director of Nursing on a full-time basis — that RN license is the entire federal requirement, with no mandated minimum years of experience or advanced degree. A DON may only cover charge-nurse duties in facilities with 60 or fewer average daily residents. In practice, most facilities hire well above the federal floor: a BSN, several years of LTC leadership experience, and often an MHA or DNS-CT certification.
What CMS actually requires vs. what facilities hire for
Federal minimum
A current, unrestricted Registered Nurse (RN) license — that is the entire federal bar under 42 CFR §483.35. There is no federal requirement for a minimum number of years of experience, an advanced degree, or a long-term-care specialty certification.
Full-time, facility-designated
The facility must designate this RN as Director of Nursing on a full-time basis — it cannot be a shared or part-time role at the regulatory level.
Charge-nurse restriction
A DON may only serve as a charge nurse (i.e., cover direct floor duties) when the facility's average daily occupancy is 60 residents or fewer — above that threshold, the DON role must stay dedicated to its own duties.
What most facilities require beyond the federal floor
In practice, most facilities hire well above the bare federal minimum: a BSN, several years of long-term-care nursing leadership experience, and often a Master's in Health Administration/Nursing or a certification like DNS-CT (Director of Nursing Services – Certified).
What the role actually owns
- Directing the entire nursing program — staffing, scheduling, and clinical practice standards
- Hiring, developing, and when necessary terminating nursing staff
- Ensuring resident care plans are followed and reflect current clinical needs
- Sitting on the QAA/QAPI committee and driving nursing-related Performance Improvement Projects
- Ensuring nursing practice stays compliant with 42 CFR Part 483 across every survey cycle
- Reporting to, and working closely with, the facility Administrator
The DON also sits on the facility's QAA committee alongside the Medical Director and Infection Preventionist — see the full QAPI committee membership requirements for how that structure works.
Job description & posting template
What a new DON inherits with PoC360
A new Director of Nursing steps into an existing citation history, an in-progress QAPI cycle, and whatever compliance tasks were already in motion. PoC360 gives them that full picture — open citations, active Plans of Correction, and the daily task scheduler already mapped to F-tags — on day one instead of week three.
Start Free Trial →Frequently Asked Questions
Does a Director of Nursing have to be a Registered Nurse?+
Yes. 42 CFR §483.35 requires the facility to designate a Registered Nurse to serve as Director of Nursing on a full-time basis — this is the core federal requirement for the role.
Does CMS require a minimum number of years of experience for a DON?+
No. Federal regulation sets no minimum years of experience, degree level, or specialty certification for the DON role beyond holding a current RN license. Facilities set their own, typically higher, bar in practice.
Can the Director of Nursing also work as a charge nurse?+
Only in facilities with an average daily occupancy of 60 residents or fewer. Above that threshold, the DON's duties must stay dedicated to the role rather than covering floor shifts.
Who does the Director of Nursing report to?+
The Nursing Home Administrator, who holds overall operational and regulatory accountability for the facility. The DON and Administrator function as the facility's core leadership pairing.
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