I agree with Gutter cat. To often staffing decisions are decided by numbers on a spreadsheet, not the reality of patient care unique to the unit.
Having managed a 'remote, rural' unit, I can identify with your concerns. I had staff RN. As the only RN, how do you manage your time regarding direct pt care, pt education and documentation, etc. and the CM duties.
How will you handle all of the unforeseen issues - staff sick day, holiday time, your personal time, etc.
Even with a plan for growth in census, you know your area, how easy will it be to hire and get that person up to speed? Is an LVN an option?
What is your relationship like with your regional manager? How/when will you have care plan and CQI meetings? The questions are many. . .
Here's a basic question.... do you feel that in your current role as direct care nurse that you have adequate time to provide the care that you desire to give your patients 90% of the time?
Like Guttercat, I have concerns about assuming so much responsibility.
Good luck and let us know what you decide.