7 Mistakes Long-Term Care Facilities Make When Hiring Directors of Nursing (And How to Fix Them)

Hiring a Director of Nursing isn't just about filling a vacancy. It's about finding the strategic leader who will shape your facility's culture, ensure regulatory compliance, and drive quality care outcomes for years to come.

Yet we see long-term care facilities across Canada make the same costly hiring mistakes over and over again. These missteps lead to high turnover, compliance issues, staff dissatisfaction, and ultimately, compromised resident care.

The good news? Every one of these mistakes is completely preventable.

We've worked with dozens of long-term care facilities on director of nursing recruitment in Canada, and we've identified the seven most common pitfalls, and exactly how to fix them.

Mistake #1: Prioritizing Clinical Credentials Over Leadership Ability

Your Director of Nursing needs to be a registered nurse, yes. But that's where the job description truly begins, not ends.

Too many facilities focus exclusively on clinical credentials and years of nursing experience while overlooking the leadership competencies that actually determine success in this role.

The Fix:

Evaluate leadership skills with the same rigor you apply to clinical qualifications. Look for candidates who can demonstrate:

• Experience building and developing high-performing teams
• Track record of navigating complex change initiatives
• Proven conflict resolution and communication skills
• Strategic thinking ability, not just operational execution
• Emotional intelligence and staff engagement capabilities

We help our clients create competency-based interview questions that reveal how candidates have actually led teams through challenging situations. A stellar bedside nurse doesn't automatically translate to an effective nursing leader.

Mistake #2: Rushing the Process Because the Position Is "Urgent"

We get it. When your DON leaves unexpectedly, the pressure is intense. You need someone yesterday.

But rushing this critical hire is how you end up back in the same position six months later: except now you've lost even more time, money, and organizational stability.

The Fix:

Build contingency plans before you need them. Consider having an interim leadership solution ready while you conduct a thorough director of nursing recruitment process.

This gives you time to:

• Properly define the role and expectations
• Conduct comprehensive candidate assessments
• Verify references thoroughly
• Ensure cultural and strategic fit
• Negotiate terms that work for both parties

At MedMatch, we specialize in long term care executive search that balances speed with thoroughness. Our success-based model means we only succeed when you get a placement that actually sticks: which is why we invest the time to get it right from the start.

Mistake #3: Failing to Define Clear Expectations and Success Metrics

Ask three different people at your facility what success looks like for your DON, and you'll likely get three different answers.

This ambiguity sets up even the most talented leaders for failure. They're shooting at a moving target they can't even see clearly.

The Fix:

Before you post the job, get crystal clear internally about:

• Specific KPIs this role will be measured against
• Priority initiatives for the first 90 days
• Authority and decision-making scope
• Reporting relationships and accountability structure
• Budget responsibilities and constraints

Document these expectations and share them transparently during the interview process. The right candidate will appreciate the clarity. The wrong candidate will often self-select out: which saves everyone time and frustration.

We work with our clients to create detailed role profiles that go far beyond generic job descriptions. This ensures alignment from day one.

Mistake #4: Overlooking Cultural Fit With Your Facility

Skills can be developed. Experience can be gained. But fundamental misalignment in values, communication style, or leadership philosophy? That's nearly impossible to fix.

We've seen technically excellent DON candidates fail spectacularly because they simply didn't mesh with the facility's culture and operational approach.

The Fix:

Be honest about your facility's culture: both the strengths and the challenges. Look for candidates whose natural working style aligns with how your organization actually operates.

Ask yourself:

• Does this candidate's leadership style match what our staff will respond to?
• Do their values align with how we prioritize resident care versus operational efficiency?
• Will they thrive in our level of autonomy, or do they need more structure?
• How do they handle the specific challenges our facility faces?

Cultural fit doesn't mean hiring people exactly like you. It means finding leaders whose approach complements and strengthens your existing team dynamics.

This is where working with specialized healthcare recruiters makes a tangible difference. We take time to understand your facility's unique culture before we ever present a candidate.

Mistake #5: Not Thoroughly Verifying Regulatory Compliance Track Record

In long-term care, regulatory compliance isn't optional: it's fundamental. Yet many facilities don't dig deep enough into a candidate's actual compliance history.

A resume might say "managed regulatory compliance," but what does that really mean? Were they maintaining existing strong standards, or turning around a struggling facility?

The Fix:

Conduct detailed reference checks specifically focused on compliance management:

• Request specific examples of how they've handled surveys and inspections
• Ask about their approach to policy development and staff education
• Verify their track record with any previous deficiencies or citations
• Understand their philosophy on proactive versus reactive compliance

We go beyond surface-level reference checks to verify that candidates have actually demonstrated the regulatory competence your facility needs. This is especially critical in the Canadian long-term care environment where standards continue to evolve.

Mistake #6: Underestimating the Importance of Change Management Skills

The healthcare landscape is constantly shifting: new regulations, staffing challenges, technology implementations, and evolving care models.

Your Director of Nursing isn't just maintaining the status quo. They're leading your facility through continuous change while keeping staff engaged and residents safe.

The Fix:

Specifically assess change management experience during interviews:

• How have they led teams through significant transitions?
• What's their approach to managing resistance and building buy-in?
• Can they provide examples of successful change initiatives they've led?
• How do they balance innovation with stability?
• What's their track record with technology adoption?

Look for candidates who view change as an opportunity rather than a burden. The best DONs don't just react to change: they anticipate it and position their teams to adapt successfully.

This forward-thinking leadership ability is exactly what separates adequate DONs from exceptional ones. It's also a key criterion in our leadership recruitment process at MedMatch.

Mistake #7: Not Having a Structured Onboarding and Integration Plan

You've finally made the hire. The hard part is over, right?

Wrong. This is where many facilities drop the ball. They assume a senior leader can just "figure it out" without structured onboarding.

Even the most experienced Director of Nursing needs time and support to understand your specific facility, staff dynamics, existing challenges, and organizational priorities.

The Fix:

Create a comprehensive 90-day onboarding plan that includes:

• Structured introductions to all key stakeholders
• Review of current policies, procedures, and recent survey results
• Clear priorities and quick wins for the first 30-60-90 days
• Regular check-ins with leadership to address questions and concerns
• Mentorship or peer connections within your organization or network

This investment in onboarding dramatically increases the likelihood of long-term success. It's also why MedMatch offers a guaranteed replacement period: because we know that successful placements require commitment from both sides.

Why These Mistakes Are So Costly

Every hiring mistake with a Director of Nursing position has cascading consequences:

• Direct costs of re-recruiting and rehiring
• Lost productivity during transition periods
• Staff turnover due to leadership instability
• Potential compliance issues and associated penalties
• Damaged reputation in the tight-knit healthcare community
• Compromised resident care outcomes

The total cost of a failed DON hire can easily exceed $150,000 when you factor in all the direct and indirect impacts.

How MedMatch Helps You Avoid These Mistakes

We've built our entire approach around preventing these common pitfalls in director of nursing recruitment in Canada.

Here's what makes us different:

Success-Based Partnership: We only succeed when you get a placement that works long-term. This aligns our incentives completely with your goals.

Thorough Assessment Process: We go deep on both technical qualifications and leadership competencies before we ever present a candidate to you.

Guaranteed Replacement Period: We stand behind our placements because we've done the work to get it right from the start.

Long-Term Care Expertise: We understand the unique challenges of LTC facilities in Canada: the regulatory environment, staffing realities, and operational complexities.

Cultural Fit Focus: We take time to understand your facility's culture and only present candidates who will thrive in your specific environment.

We're not a transactional staffing agency. We're a strategic partner in building the leadership team that will drive your facility's success for years to come.

Ready to Find Your Next Director of Nursing?

If you're facing a DON vacancy: or know you will be soon: let's talk about how we can help you avoid these costly mistakes and find a leader who will truly strengthen your organization.

Our long term care executive search process is designed specifically for the Canadian healthcare environment, and we're ready to put that expertise to work for your facility.

Get in touch with us at info@medmatch.ca to discuss your needs, or visit our leadership recruitment page to learn more about our approach.

Your residents deserve exceptional care. Your staff deserves strong leadership. And your organization deserves a hiring process that actually delivers both.

Let's work together to make your next Director of Nursing hire your best one yet.