Description

1. POSITION SUMMARY

According to prescribed policies and procedures of the organization including all applicable state and federal regulations and under the general supervision and in conjunction with the Hospice Medical Director, the Nurse Practitioner is responsible for performing patient medical examinations and Palliative Care visits beyond face-to-face encounters required to certify patient’s eligibility for the Medicare Hospice Benefit after 6 months of hospice care.  Documents visits in the patient’s clinical record and the face-to-face encounter on required forms. Provides medical care services and Palliative Care intervention for hospice patients on an as-needed basis. The Hospice Nurse Practitioner communicates effectively with the Hospice Medical Director, Director of Clinical Services and the Hospice Interdisciplinary Team. In the Palliative Care Program, the Nurse Practitioner is responsible to work collaboratively with the attending physician and other members of the interdisciplinary group to deliver Palliative Care and related healthcare services to patients and their families.

1. PRIMARY RESPONSIBILITIES

As the Hospice Nurse Practitioner:

The following activities shall comprise the primary responsibilities of the Nurse Practitioner:

Re-certification of Patients for Hospice Care

1. 1. 1. 1. Reviews patient's medical eligibility for hospice services by performing a nursing examination and documenting the same in the clinical record in order to gather clinical findings to verify the patient’s continued medical eligibility for the hospice benefit prior to the 180^th day (6 month) recertification and each subsequent recertification.
         2. Performs and documents each face-to-face encounter and each subsequent recertification encounter no more than thirty (30) calendar days prior to the start of each benefit period.

Intervention/Patient Care Coordination

1. As needed, performs medical examinations and patient home visits beyond those required for the face-to-face encounters.
2. As directed, may assist in managing the patient’s terminal condition including prescribing medication or care by coordinating with the attending physician or Hospice Medical Director.
3. Provides consultation for palliative and end-of-life care issues on an as-needed basis and as directed by the Hospice Medical Director.

Leadership/Professionalism

1. Maintains current knowledge of hospice principles and practices.
2. Develops and maintains cooperative working relationships with hospice staff.
3. Able to exercise independent judgment, critically analyze situations, and make recommendations using appropriate problem-solving skills.
4. Able to function effectively as a member of a team.
5. Must have excellent interpersonal skills and the ability to work and communicate within
   all levels of the organization.
6. Effectively communicates in interpersonal, professional and public relationships.
7. Participates in the Quality Assessment/Performance Improvement Program of the agency
   as appropriate and needed.

As the Palliative Care Nurse Practitioner

1. Performs Palliative Care visits with patients enrolled on the Palliative Care Program.
2. Completes history and physical examinations by evaluating the patient's medical condition and health history, ordering and interpreting results from laboratory and diagnostic tests or procedures, diagnosing health conditions and documenting the findings in the patient's medical record.
3. Assists with diagnosis, treatment and management of acute and chronic health conditions.
4. Manages chronic health conditions and terminal illnesses by developing an individualized plan of care, prescribing medications and/or treatments, obtaining consultations or making referrals and coordinating Palliative Care services.
5. Makes recommendations to the Palliative Care Physician and attending physician regarding patient eligibility for certification and recertification for Palliative Care.
6. Reviews clinical information, coordinates and oversees patient care in consultation with the Palliative Care Interdisciplinary Group and other healthcare practitioners.
7. Documents clinical findings in accordance with the Palliative Care Program policies and procedure; signs and dates that they performed the visit where applicable.
8. Prescribes medications, including controlled substances, to the extent permitted by licensure.
9. Assures that patient receives appropriate measures to control symptoms through collaboration with interdisciplinary group members.
10. Reviews and develops practice guidelines, standards and protocols for treatment, and proposes options for interventions based on the current medical literature.
11. Attends and participates in Palliative Care Interdisciplinary Group meetings.
12. Consults the collaborating physician and/or organizational leadership when the patient's plan of care is outside standardized practice and protocols. 
13. Provides education and training in Palliative Care services to patients, families, peers, members of the interdisciplinary group and other healthcare personnel.
14. Collaborates with skilled nursing facility and hospital staff to coordinate care and services for the hospitalized or facility-based patient as needed.
15. Participates in discharge planning for managing patients enrolled in the Palliative Care Program.
16. Participates in the discussions related to and completion of Advance Directives and care planning.
17. Provides consultation services with other care providers and referral sources.
18. Adheres to standards of practice in Palliative Care.
19. Visits with the patient and family/caregiver are conducted with the purpose of:
    1. Performing a clinical assessment.
    2. Determining pain and symptom management needs in collaboration with the patient and family/caregiver and the attending physician.
    3. Managing and coordinating care and services.
    4. Meeting patient and family/caregiver care and educational needs as requested.
20. Functions under the direction of the hospice medical director/Palliative Care Physician and in accordance with state regulations related to scope of practice.
21. Functions as a member of the interdisciplinary group and participates in the case management, care coordination and determining the plan of care.

1. Education:

1. Master’s degree in nursing from a school accredited by a nursing accrediting association recognized by the U. S. Department of Education.

OR

1. Master’s degree in nursing and completed a post-master’s program that focuses on an advance practice nursing specialty from a school accredited by a nursing accrediting association recognized by the U. S. Department of Education.

1. Experience:

1. Minimum of two (2) years’ experience as a Nurse Practitioner.
2. Must understand palliative care and/or hospice care and services.
    

1. Licensure, Registration, and/or Certification:
   1. Must have a current Registered Nurse license in good standing in the State of Ohio in accordance with the Ohio Board of Nursing in accordance with the Ohio Revised Code 4723
   2. Currently certified as a Nurse Practitioner by a national certifying agency that is accredited by the American Board of Nursing Specialties and/or the National Commission for Certifying Agencies per the State of Ohio’s Board of Nursing.
   3. Valid driver’s license and reliable transportation that is insured in accordance with Ohio requirements.

Qualifications