Hospice & Palliative Care Nurse Practitioner

The Nurse Practitioner (NP) – Hospice & Palliative Care is an advanced practice provider responsible for delivering high-quality hospice and palliative care services across home, facility, and inpatient settings. The NP conducts hospice face-to-face (F2F) encounters, collaborates closely with interdisciplinary team members to manage symptoms and support goals-of-care discussions, participates in interdisciplinary team (IDT) meetings, and provides after-hours clinical support through a rotating on-call schedule.

This position also provides cross-coverage for the Palliative Care Nurse Practitioner, ensuring continuity of care for patients across the hospice and palliative care continuum.

Primary Job Duties

Hospice Face-to-Face Encounters

• Conduct and document Medicare-required hospice face-to-face visits for patients entering or

recertifying for the third benefit period and beyond.

• Assess disease progression, functional decline, symptom burden, and continued hospice eligibility.
• Collaborate with hospice physicians and medical directors regarding prognosis and certification recommendations.
• Complete timely, accurate, and compliant documentation in the electronic medical record.

Clinical Symptom Management

• Partner with hospice nurse case managers to evaluate and manage pain, dyspnea, nausea, agitation, delirium, anxiety, and other symptoms associated with serious illness.
• Develop and implement evidence-based treatment plans within scope of practice.
• Prescribe medications and treatments in accordance with state regulations and organizational policies.
• Provide clinical consultation to hospice staff regarding complex symptom management issues.
• Participate in difficult goals-of-care, advance care planning, and family meetings as requested.
• Complete necessary paperwork such as FL2 and FMLA forms.

Interdisciplinary Team Participation

• Attend and actively participate in assigned Interdisciplinary Team (IDT) meetings.
• Collaborate with physicians, nurses, social workers, chaplains, bereavement counselors, pharmacists, and other team members to develop and review patient plans of care.
• Contribute clinical recommendations to support quality care and regulatory compliance.

Palliative Care Cross-Coverage

• Provide clinical coverage for the Palliative Care Nurse Practitioner during periods of absence, scheduled leave, or increased patient volume.
• Perform palliative care assessments and follow-up visits as needed.
• Assist with symptom management, advance care planning, and care coordination for palliative care patients.
• Collaborate with referring providers and community partners to ensure continuity of services.

On-Call Responsibilities

• Participate in a rotating after-hours and weekend call schedule.
• Provide clinical guidance to hospice staff regarding urgent symptom management concerns.
• Respond to patient and family needs consistent with organizational expectations and standards of care.
• Coordinate with hospice physicians and other providers as necessary to support patient care needs.

Quality and Compliance

• Maintain knowledge of CMS Conditions of Participation, Medicare Hospice Benefit regulations, state licensing requirements, and organizational policies.
• Ensure clinical documentation supports regulatory compliance and quality outcomes.
• Participate in quality improvement initiatives and performance improvement activities.
• Assist with clinical education and staff development as appropriate.

Job Specifications

1. Education: Graduate of an accredited school of nursing, either through an AD, Diploma or BSN program. Graduate of a Masters degree in nursing program with a major or post-masters as a nurse practitioner. Certification in hospice/palliative care preferred (CHPN, ACHPN)

2. Licensure / Certifications: Current license to practice professional nursing in the State of North Carolina / South Carolina. Approval for practice as a nurse practitioner by the North Carolina Board of Nursing and the North Carolina Board of Medical Examiners.

3. Experience: Minimum of five years general medical experience in inpatient, outpatient and nursing home settings. Two years as a nurse practitioner preferred. Experience in an acute care setting desirable. Demonstrated competence in leadership and teaching. Demonstrated achievement and familiarity with administrative nursing techniques.

4. Essential Technical / Motor Skills: Good hand/eye coordination and manipulative skills when performing examination, providing treatments, injections, use computer, etc. Speaking clearly to communicate with patients, families, physicians and staff regarding patient’s condition and care.

Must be able to communicate and be literate in the English language. Working knowledge in the use of personal computer workstations and Microsoft Windows environment for delivering patient care to include placing orders for clinical services, reviewing results from clinical tests and documenting delivered care.

5. Interpersonal Skills: Ability to deal with the public, co-workers, patients, guests, outside agencies and physicians in a professional manner. Ability to positively interact with patients, families, physicians and staff in order to effectively care for the patients. Competence at providing leadership and direction to supervisees. Strong interpersonal skills to manage working relationships with departmental leadership.

6. Essential Physical Requirements: Ability to lift and/or maneuver objects weighing at least 45 pounds or less in the assessment and implementation of patient care. Requires pushing, moving, lifting of patients.

7. Essential Mental Abilities: Must be able to assess a patient’s condition, formulate a Plan of Care, implement appropriate interventions to meet patient/family outcomes. Requires higher level of mental faculties accompanied by short and long-term memory. Strong problem solving, analytical and critical thinking skills.

8. Essential Sensory Requirements: Must be able to assess patients and to utilize sight to implement and evaluate Plan of Care. Utilize hearing to auscultate lung sounds, bowel sounds and effectively communicate with patients, families, physicians, and staff.

9. Exposure to Hazards: Frequent exposure to blood and body fluids, infectious diseases, needle puncture wounds. May be exposed to dangerous animals and traffic hazards while home visiting. May encounter patients and other situations that present a potential threat to personal safety. May encounter temperature changes and weather extremes.

10. Other - Hours of Work: Flexible schedule to accommodate staffing needs, which may include weekends/holidays, rotating shifts and on-call.

11. Population Served: Lower Cape Fear LifeCare service area, internal and external.

12. Driving: May be required to drive. Must have reliable transportation. Will be subject to the Safe Driver Policy.