Supervising RN - High-Acuity Adult Family Home (AFH)

Location: Waukesha, Washington, Ozaukee Counties Location: Waukesha, Washington, Ozaukee Counties Job Type: Full-Time About Support Plus Assisted Living (SPAL): SPAL is a physician-owned and operated Adult Family Home (AFH) enterprise. We specialize in moderate-to-high behavioral and medical acuity placements. We operate on superior clinical protocols, aggressive incident management, and data-driven oversight. The Role: We are seeking a highly independent Supervising RN to serve as the clinical director under the physician-owner. You will bypass the standard administrative bureaucracy and work directly with ownership to refine and execute clinical protocols, manage specialized behavioral intakes, and maintain strict DHS 88 compliance. You will not be performing standard floor nursing; you will be managing the clinical architecture of the facility, utilizing and training the EHR system, behavioral training and supervising a team of direct-care staff trained in AFH standards and advanced behavioral techniques. Core Responsibilities: Clinical Intake & MCO Coordination: Conduct rigorous pre-admission medical and behavioral baseline assessments. Document clinical justifications required to secure and maintain Enhanced Behavioral Single Case Agreements (SCAs) with MCOs. Staff Supervision & Ratios: Oversee a team of direct care workers (operating on a 2:4 day / 1:4 night matrix). Ensure strict adherence to CPI/Mandt (Behavioral) de-escalation protocols. Manage the standard scheduling, ordering and activation of our PRN "Surge" staff during acute behavioral escalations. EHR Management: Oversee all clinical documentation within EHR and Medications. Conduct routine audits of Medication Administration Records (MARs), behavioral tracking, and incident reports to ensure zero regulatory vulnerabilities. Medication Management: Audit psychotropic medication regimens, manage PRN administration protocols, and act as the primary liaison between the facility, the physician-owner, and external pharmacies. DHS 88 Compliance: Maintain absolute survey readiness at all times. Ensure all resident Behavioral Support Plans (BSPs), Individualized Service Plans (ISPs), and the facility Program Statement are perfectly aligned and defensible. Required Qualifications: Active, unencumbered Registered Nurse (RN) license in the State of Wisconsin. Demonstrated management experience in an Adult Family Home (AFH), Community Based Residential Facility (CBRF), or specialized behavioral health setting. Preferred Mastery of Wisconsin Administrative Code Chapter DHS 88. Experience navigating Wisconsin Managed Care Organizations (Family Care, IRIS) and understanding the mechanics of high-acuity waiver placements. Proficiency with electronic health records (Yardi experience is a massive advantage). Clinical spine: The ability to firmly direct direct-care staff, clinically justify interventions to MCO Care Managers, and manage crisis protocols without hesitation. Preferred Certifications: (If not you will be trained) Train-the-Trainer certification in CPI (Crisis Prevention Institute) and Mandt. RBT Compensation & Benefits: Starting around 100K We offer Health insurance, Dental, Vision and 401K matching

Created: 2026-03-08