Primary function is to perform hospice admissions at the patient’s place of service (hospital, skilled nursing facility (SNF), assisted living facility (ALF), and private home) including the hospice item set. Coordinates and completes admissions/resumptions of care for hospice & palliative care patients in accordance with state and federal regulations, accrediting body and agency standards in facility and home setting utilizing the nursing process which includes, assessment, planning, intervention, and evaluation. Facilitates smooth transition from admission to assignment of case manager; begins discharge planning process for patients as indicated upon admission; communicates and performs hand-off to the case manager.
Performs hospice admissions to patients in a facility setting (hospital or SNF) based on capacity and agency need. Performs initial and comprehensive assessment and develops initial and comprehensive plan of care for facility patients. Evaluates and modifies plan of care, level of care and place of service in collaboration with other members of the IDT and the attending physician/hospice physician.
Develops a safe and appropriate initial plan of care, communicates initial and comprehensive needs of patient/family to team and to case manager. Makes recommendations for equipment, supplies, and other services as indicated. Completes performance assessments and ensures the plan of care will effectively and safely meet patient and families needs and sets the team up for success and ensures the initial patient/family care plan facilitates a top box patient and family experience.
Competently performs palliative care admissions, resumption’s of care, and OASIS data collection. Performs Hospice & Palliative Care admissions/and evaluative consultations using the nursing process. Coordinates all services (including those disciplines/services necessary to meet immediate needs, medications, DME and medical supplies and collaborates with members of the hospice interdisciplinary team (IDT) and facility team to provide consistent patient care.
Collaborates with manager, team leader and administrative assistants to triage and prioritize incoming referrals for both hospice and palliative care patients. Develops and provides hospice and palliative care education to inpatient hospital and facility staff as indicated and directed by manager.
Acts as an expert resource to hospital and facility staff and home care liaisons regarding hospice and palliative care services.
Participates in IDT meetings.
Completes routine hospice & palliative care visits and/or supervisory visits based on departmental needs. Accurately maintains and updates the patient's clinical records according to agency, state and federal guidelines.
Participates in instruction of paraprofessional staff on a timely basis and in accordance with agency, state and federal regulations. Orients and mentors new staff as requested.
Utilizes proper body mechanics, assistive devices and safety techniques when performing various patient positioning/repositioning and transporting duties, which require lifting, and pushing/pullingScheduled Hours
40 hours/week hours M-F; 3- 12 hour shifts and a 4hr shift, 4 - 10hr shifts or Mon-Fri 0800-1630.
Licenses & Certifications
Registered Nurse license issued by the state in which the team member practices, and
Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association (AHA) needs to be obtained within 6 months unless department leader has determined it is not required, and
A valid drivers license issued by the Division of Motor Vehicles, or
Driver license issued by the state of Illinois.
Associate's Degree in Nursing.
Required Functional Experience
Typically requires 3 years of experience in nursing that includes experiences in home health, hospice, medical/surgical, emergency, ICU or oncology or similar experience.
Knowledge, Skills & Abilities
Competent in the principles of deformity prevention, normal range of motion, body mechanics and body alignment; and fundamental principles of human behavior and an understanding of the effects of stress upon individuals and groups.Excellent awareness and perception skills, for the purpose of assessing a patient's needs, concerns and to recognize changes in their health condition.Excellent communication and interpersonal skills.Excellent decision making and critical thinking skills, with the ability to work independently and make sound judgments.Excellent prioritization and organizational skills.Must possess and provide proof of valid Driver License and a registered, function car with adequate insurance coverage.