1. Review all patient /family hospice plan of care(s) and perform updates as required. Review Comprehensive Assessment.
2. Coordinate all care plans with facility MDS 3.0 Care plans as appropriate to ensure coordinator of care between hospice and facility plan of care.
3. Update Medication / Treatment Records as required.
4. Direct, lead, mentor assigned team of patients and staff.
5. Assist IDG with coordination of services and utilization of community resources in patient care.
6. Orients IDG members, including nursing and emotional support staff, and other therapy services to care planning processes.
7. Assures that all clinical documentation and daily activity logs for staff and ancillary services are submitted in a timely and accurate manner and in compliance with regulatory guidelines.
8. Participates in student preceptoship programs.
9. Facilitates communication between team members and the patient’s physician to assure appropriateness of care and assists IDG members with follow-through regarding ongoing patient problems related to the plan of care.
10. Performs clinical record review and facilitates needed changes as indicated in visit notes, etc. in the Hospice Plan of Care / Medication and Treatment Record. Participates in monitoring of quality assurance indicators and implementation of suggested changes.
11. Provides direct care staff with information and tools necessary to support the learning process and to perform accurately, especially related to the hospice plan of care.
12. Directly responsible for the orientation of newly hired clinical personnel.
13. Performs ongoing quality improvement / quality assurance review of all active clinical records.
14. Performs quality improvement / quality assurance audit of all closed records within 30 days of discharge.
15. Schedules and performs LPN supervisory visits as required by state regulations.
16. Ensures all aide supervision is performed as dictated by regulation.
17. Performs review of daily clinical documentation. Will assist clinical staff with meeting documentation requirements.
18. Will provide ongoing assessment of newly hired clinical staff to ensure compliance and job satisfaction. Will communicate identified problems with the Clinical Director.
19. Will ensure all clinical staff attends, participates and are compliant with scheduled employee inservices as required by state regulations.
20. Will maintain a record of each clinical personnel inservice attendance to ensure compliance.
21. Will offer staff support to all clinical personnel in attempts to maintain or improve employee morale.
22. Will attend, direct, and coordinate in collaboration with the Clinical Director and other Team Leaders, specific IDG conferences to ensure compliance and appropriate use of allocated time.
23. Will assist IDG members with coordination of services and utilization of community resources in patient care.
24. Participates in monitoring of quality assurance indicators, including the Problem Prone Areas and ensures implementation of suggested changes.
25. Pursues development of direct care staff through making observations during home visits, planning patient home visits with appropriate personnel.
26. Mentors, guides, and intervenes when necessary in care given by direct care staff.
27. Rotates administrative on-call support with other Assistant Clinical Directors.
28. Provides direct care staff with information, resources and tools necessary to support the learning process and to perform accurately.
29. Assist with the coordination and manage the daily workload of staff providing direct patient care by offering guidance and oversight with the self scheduling of clinical staff.
30. Assist in the coordination and scheduling of staff providing direct patient care for work hours assignments, on call time, and employee vacation time off by assisting the Clinical Director and/or other Team Leader/Assistant Clinical Directors.
31. Responsible for ensuring patient care visits are made and are in compliance with any/all clinical personnel call-outs.
32. Perform, Assist (as necessary) and schedule Continuous Care, Watch Visits and/or EvenMore Care staffing duties as deemed appropriate based on the patient’s current condition.
33. Assist, direct, schedule, monitor and record the education and in servicing of staff.
34. Perform all new hire / annual competency exams in a timely manner.
35. Performs and completes all required performance evaluations on clinical personnel as required.
36. Performs, in coordination with the Clinical Director, disciplinary and/or educational counseling, including the required documentation, as necessary for clinical personnel.
37. Monitor and ensure all recertification documentation and procedures are followed, as indicated by patient status.
38. Monitor and ensure all Face to Face Encounter visits are performed as required. Immediately notify the Clinical Director when discrepancies are identified.
39. Develop orientation and inservice programs for nursing homes and other providers as deemed necessary, based on the needs of the staff, regulatory requirements and from quality improvement indicators.
40. Work in conjunction with the hospice medical director, to ensure recertifications are performed, timely and discussion occurs during the IDG conference meetings.
41. Monitor newly hired personnel to assure all policies are being met and patient care is being delivered in the manner intended.
42. Assure the coordination and update(s) of the Plan of Care for each patient, as directed by the Comprehensive Assessment.
43. Assist in working with direct patient care staff; determine job objectives and expectations, work methods and performance standards. Evaluate employee performance.
44. Assist Clinical Director and marketing staff in assuring that Team Building, General hospice, Criteria, and facility requested inservices are performed at each contracted facility, as directed.
45. Assist in working with direct patient care staff; determine job objectives and expectations, work methods and performance standards. Evaluate employee performance.
46. Triage incoming calls from clinical staff during business hours, providing guidance, direction, and support in a professional manner.
47. Develop and maintain collaborative relationships with all providers.
48. Any other duties requested by the Clinical Director, to assist the Clinical Director, Assistant Clinical Directors in the day to day delivery of patient care and staff support.
49. Use a customer service approach with physicians, referral sources, patients, co-workers, and others.
50. Responsible for maintaining complete confidentiality of patient records, and all other confidential information which may be received during the course of patient care, including financial information and personnel records.
51. Monitor and ensure that all patients receive the appropriate level of care, based on patient conditions and the needs of the patient and family.
52. Comply with policies and professional standards.
53. Act independently and responsibly to perform duties on a consistent basis.
54. Demonstrate financial responsibility in developing and facilitating delivery of care.
55. Perform duties necessary to meet the requirements assigned by Carrefour Associates, L.L.C.
56. Must work well with others.
57. Any other duties assigned to you by the Clinical Director, Executive Director, and / or Carrefour Associates personnel.
58. Must be able to stand or sit for extended periods of time.
59. Must be able to lift, at minimum 25 lbs without restrictions.
60. Must be available for Even More Care, Continuous Care, and/or Watch Status duties as deemed necessary.
61. Must be available for after-hour on-call duties as deemed necessary.
62. Promote, provide, and assist with the Gift-of-A-Day program / activities, as deemed necessary.
63. Demonstrate a pro-active approach to problems, continue to increase knowledge base related to hospice/ palliative care and pharmacy and medication issues which will be shared with clinical staff.
64. Demonstrate a growth-oriented, positive attitude.
65. Must maintain a current, unrestricted state specific nursing license.
o Registered Nurse with current license or permit from State Board of Nursing. (As of July 1, 2003, nurses residing in a state designated as a compact state may only hold one nursing license as directed by the Nurse Licensure Compact Law).
o Two years experience in home health or hospice nursing required.
o Progressive supervisory or leadership experience required.
o Requires well developed communication and interpersonal skills.
o Requires demonstrated time management skills including the ability to prioritize workloads and deal effectively with multiple priorities.
o Must be available for on call assignments during business and non-business hours to guide clinical staff and on call / after hour personnel.
o Requires ability work autonomously with minimal supervision.
o Must be able to handle sensitive personnel issues effectively.
o Must possess excellent stress management skills.
o Must demonstrate an above average knowledge of pain management, symptom management, palliative care, as well as drugs, side effects, contraindications with medications commonly used in the hospice setting.
o Must maintain ongoing continuous education related to the field of nursing and hospice trends. Maintain state required CEU’s (based on state of licensure).
o Must demonstrate an above average knowledge of hospice eligibility criteria
o Must exhibit or demonstrate the ability to learn computer skills related to required clinical software and electronic clinical record utilization.