Who is at the top of the chain of command in a long-term care facility?

In a long-term care facility, the Director of Nursing (DON) holds the highest position in the chain of command related to nursing staff and patient care. The DON is responsible for overseeing the nursing department, ensuring that policies are followed, managing nursing staff, and maintaining compliance with state and federal regulations. The DON often plays a crucial role in decision-making regarding patient care, staff education, and overall facility management.

This role is essential because it involves not only administrative duties but also direct oversight of the nursing procedures that impact patient health and safety. Charge and staff nurses, while critical to day-to-day operations and hands-on patient care, report to the DON. Similarly, Assistant Directors of Nursing (ADON) and Nurse Managers work under the supervision of the DON, assisting in specific functions and departmental management. Therefore, in the hierarchy of a long-term care facility, the DON is unequivocally at the top, making this choice the correct answer.