Hospice Nurse Practitioner (Craig & Steamboat Springs)
General Statement of Duties: The Hospice Nurse Practitioner provides advanced clinical care, consultation, and education to hospice patients and families in home and community-based settings. As a member of the hospice interdisciplinary group, the Nurse Practitioner assesses and manages pain and symptoms, supports individualized plans of care, conducts required face-to-face encounters when assigned, and collaborates with the Hospice Medical Director, attending physicians, and hospice team to promote comfort, dignity, continuity, and regulatory compliance.
Supervision Received: Reports to the Director of Home Services.
Supervision Exercised: None.
Essential Functions:
1. Provides hospice and palliative clinical services within the Nurse Practitioner’s education, national certification, Colorado scope of practice, prescriptive authority, credentialing, and organizational privileges.
2. Completes comprehensive and focused histories and physical examinations. Evaluates disease progression, functional decline, symptom burden, psychosocial factors, medication effectiveness, and safety concerns.
3. Diagnoses and treats acute and chronic symptoms related to the terminal illness and related conditions, including pain, dyspnea, nausea, anxiety, agitation, constipation, wounds, and other distressing symptoms within authorized scope.
4. Performs home, facility, telehealth, and other patient visits as operationally appropriate and legally permitted. Provides timely clinical intervention for changes in condition and urgent symptom-management needs.
5. Conducts hospice face-to-face encounters for the third benefit period and subsequent recertification periods when assigned and eligible. Documents clinical findings promptly and communicates those findings to the certifying hospice physician.
6. Participates in interdisciplinary group meetings as scheduled. Contributes clinical recommendations, reviews patient status, and supports the development, revision, and implementation of individualized plans of care.
7. Collaborates with the Hospice Medical Director, attending physicians, pharmacists, nurses, social workers, chaplains, aides, therapists, and other team members to ensure coordinated, person-centered care.
8. Provides patient and caregiver education regarding disease progression, medications, symptom management, safety, goals of care, and what to expect through end of life using clear, compassionate, and culturally responsive communication.
9. Supports advance-care planning and goals-of-care conversations within professional scope and organizational policy. Accurately documents patient preferences and escalates complex ethical or clinical issues.
10. Completes accurate, timely, and compliant documentation in the electronic health record, including assessments, orders, clinical rationale, response to treatment, care coordination, and required attestations.
11. Provides clinical consultation and education to hospice staff. Serves as a resource for assessment, medication management, symptom control, and palliative-care best practices.
12. Participates in quality assessment and performance improvement activities, chart review, utilization review, incident follow-up, clinical protocol development, and regulatory readiness.
13. Practices in accordance with HIPAA, infection prevention, controlled-substance requirements, professional standards, Northwest Colorado Health policies, and applicable federal and Colorado requirements.
14. Participates in orientation, training, and continuing education for staff and students as assigned.
15. Provides after-hours, weekend, holiday, or on-call clinical support based on program needs and established coverage expectations.
16. Performs other related duties as assigned. Management retains the right to modify responsibilities consistent with the essential purpose of the position.
Role Limitation: This position does not replace the federally required physician responsibilities of the Hospice Medical Director or certifying hospice physician. Terminal-illness certifications and recertifications remain physician functions. The Hospice Nurse Practitioner may perform qualifying face-to-face encounters and provide clinical findings to the certifying physician, consistent with applicable law and payer requirements.
Education: Master’s or doctoral degree from an accredited Nurse Practitioner or advanced practice registered nursing program required. Current national board certification as a Nurse Practitioner in a population focus appropriate to the patients served, such as Family, Adult-Gerontology Primary Care, or Adult-Gerontology Acute Care, as approved through credentialing.
Experience: Two years of Nurse Practitioner clinical experience required. Hospice, palliative care, geriatrics, home-based care, oncology, or complex chronic-disease experience strongly preferred. Demonstrated experience assessing and managing pain and complex symptoms in medically fragile or seriously ill adults required. Experience collaborating with interdisciplinary teams and providing care in patients’ homes or long-term-care settings preferred. Experience with electronic health records and compliant clinical documentation required.
Knowledge, Skills and Abilities:
1. Advanced clinical assessment, diagnostic reasoning, treatment planning, prescribing, and evaluation skills within authorized scope.
2. Knowledge of hospice philosophy, palliative care, Medicare hospice benefit requirements, end-of-life symptom management, and interdisciplinary care.
3. Ability to recognize clinical decline, emergencies, medication risks, caregiver distress, abuse or neglect concerns, and other safety issues and respond according to policy.
4. Ability to communicate difficult information with clarity, compassion, neutrality, and respect for patient and family values.
5. Ability to maintain professional boundaries and provide equitable, trauma-informed, culturally responsive care to diverse patients and families.
6. Ability to work independently in variable environments while consulting and escalating appropriately.
7. Strong organization, prioritization, follow-through, documentation, and problem-solving skills.
8. Ability to use electronic health records, secure communications, telehealth tools, and standard office technology.
Requirements:
1. Active, unrestricted Colorado Registered Nurse and Advanced Practice Registered Nurse authority in the appropriate role and population focus.
2. Active Colorado prescriptive authority appropriate to the role. Full prescriptive authority preferred. Any provisional authority must meet applicable mentorship and practice requirements.
3. Current DEA registration, including authority appropriate for prescribed controlled substances, and compliance with all applicable prescribing requirements.
4. Eligible for credentialing and privileging. Maintains NPI and Medicare/PECOS enrollment or opt-out status as required for assigned services and billing.
5. Current CPR or Basic Life Support certification.
6. Valid Colorado driver’s license and reliable transportation. If a personal vehicle is used for agency business, proof of automobile insurance meeting organizational requirements is required.
7. Satisfactory completion of required credentialing, background checks, health screenings, immunizations, training, and competency validation.
8. Maintains all licenses, certifications, registrations, professional liability requirements, and continuing education necessary for the position.
Physical Requirements:
1. Ability to travel throughout the service area and enter homes and facilities with variable accessibility and environmental conditions.
2. Ability to sit, stand, walk, bend, reach, and perform clinical examinations for prolonged or intermittent periods.
3. Ability to carry clinical equipment and supplies and to assist with patient positioning or mobility consistent with training, safety procedures, and available assistance.
4. Ability to communicate effectively in person, by telephone, and through electronic systems and to respond to urgent clinical needs within assigned coverage expectations.
Working Conditions:
1. Work is performed in private homes, assisted living and skilled-nursing settings, clinics, offices, and other community locations. Lighting, acoustics, air quality, temperature, cleanliness, animals, tobacco smoke, road conditions, weather, and other environmental factors may be variable or unpredictable.
2. The schedule may include evenings, weekends, holidays, and on-call or after-hours coverage based on program needs.
3. This position has been classified as Patient-Facing, a position in which the incumbent could reasonably be expected to routinely interact with patients and/or patient family members. Employees in Patient-Facing positions are exposed to healthcare conditions that may require additional training, immunizations, and use of Personal Protective Equipment (PPE).
This description is intended to describe the essential job functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.
