The Advanced Registered Nurse Practitioner (ARNP) provides comprehensive and efficient direct primary or consultative patient care under protocol with hospice physician staff. Utilizes clinical expertise and participates in diagnostic and management decision making while promoting maximization of quality of life for the Company’s patients and caregivers.
In additional to the primary clinical responsibilities, the ARNP-Preceptor is responsible for assisting the Medical Director with orienting, teaching and mentoring the ARNPs with regards to clinical skills, operational goals, and documentation standards. Participates in the planning and implementation of orientation and on-boarding for new ARNP team members. Also provides ongoing mentoring over the first year of new ARNPs’ employment to provide ongoing oversight and training in the domains of clinical expertise, documentation accuracy and completeness, and operational efficiency. Helps identify specific areas within these domains needing more intensive study or training, and in conjunction with the Medical Director, communicates these to the ARNPs, sets specific performance goals, and monitors their progress in achieving established goals.
- Master’s degree in nursing
- ARNP certification recognized by CMS for Medicare billing
- Licensure by state of Florida to work as ARNP
- Current DEA license
- Knowledge and experience in medical practice and symptom management
- Advanced clinical skills which allow thorough patient assessments and management for any patient with advanced chronic disease as well as for those near the end of life
- Ability to work under protocol with multiple physicians in multiple settings
- Basic computer skills including use of email and word processing (Microsoft Outlook and Word or equivalent programs)
- Strong interpersonal skills, communication, collaboration, and conflict resolution
- Ability to manage multiple priorities simultaneously and effectively handle the emotional stress of the workload
- Ability to work independently exercising discretion and independent judgment
- Ability to work in collaboration with other disciplines within the Organization
- Certified by appropriate hospice nursing organization within two years of hire date
- Ability to travel to off-site locations
- Valid driver's license and automobile insurance per Company policy; must have reliable transportation to be able to meet visit schedule
- Must be able to physically access any home in any area of Company service area, i.e., navigate stairs, and narrow spaces, tolerate heat and lack of air conditioning
- Certification from HPNA obtained within two (2) years of taking the position
- Satisfactorily complete competency requirements for this position
Responsibilities of all employees:
- Represent the Company professionally at all times through care delivered and/or services provided to all clients
- Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse
- Comply with Company policies, procedures and standard practices
- Observe the Company's health, safety and security practices
- Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company
- Use resources in a fiscally responsible manner
- Promote the company through participation in community and professional organizations
- Participate proactively in improving performance at the organizational, departmental and individual levels
- Improve own professional knowledge and skill level
- Advance electronic media skills
- Support the Company’s research and educational activities
- Share expertise with co-workers both formally and informally
- Participate in Quality Assessment Performance Improvement activities as appropriate for the position
- Provide direct primary or consultative patient care through home visits, as well as clinic/nursing home/assisted living/inpatient unit/hospital visits, as designated by the Medical Director.
- Work directly under protocol with physicians from the Company’s medical staff.
- Provide clinical expertise and participate in interdisciplinary team decisions regarding diagnosis and medical management of patient/family needs, assuring that the highest quality of medical care is provided and that continuity and comprehensiveness of care is maintained in a cost-effective manner.
- Consult to patients’ primary and attending physicians regarding integration of patients’ hospice care and primary or other care.
- Report regularly to physician staff regarding clinical care provided.
- Make visits to care for patients to meet assigned productivity goals.
- Evaluate patients referred to hospice for eligibility according to current guidelines and make referrals, as
- Work cooperatively with the Patient Access/Admissions Department and other staff to facilitate timely provision of services to potential Company patients.
- Utilize practice opportunities to provide expert nursing care to patients, to evaluate nursing practice, and to provide clinical learning activities for case managers, IDT members, and students.
- Influence nursing practice by participating in patient care advocacy issues directed toward improving practice and the quality of patient care.
- Act as a role model for professional practice by integrating all components of the professional role: clinical practice, consultation, collaboration, leadership, education, and research/evaluation.
- Collaborate with all disciplines within the Company and community to develop effective patient care programs.
- Respond to clinical emergencies as an expert consultant under protocols to Case Managers (i.e., oncologic emergencies, high risk or potential).
- Participate in after-hour and weekend hospice house rounding coverage for hospice patients.
- Participate in providing after-hour and weekend FTFE evaluations, as required, for prospective hospice patients.
- Provide crossover coverage to all contracted facilities; including, but not limited to, hospitals, ALFs, Nursing Homes, and, as needed, in patient’s homes.
- Maintain defined patient care data for clinical activities.
- Maintain accurate record of administrative, non-billable activities.
- Complete thorough and accurate medical documentation to support proper CPT and ICD-10 coding on all patients seen at the time of service.
- Complete billing documentation and submission on a daily basis for each day’s activities.
- Contribute to Performance Improvement efforts of medical documentation by Company staff.
- May contribute to research efforts of the Company by actively recruiting research subjects.
- Promote the Company’s programs to nursing homes, ALFs, HMOs, hospitals, and other referral sources.
- Actively participate in ongoing education about our Company and services to our community partners, referring providers, and general public.
- Attend the Company’s Medical Staff meetings regularly (a minimum of 50% of all scheduled monthly staff meetings) and review minutes of meetings not attended within 5 days of their being made available.
- Represent the Company at appropriate local, state, national, and international forums.
- Evaluate patient care outcomes and propose solutions.
- Participate in appropriate Company-wide committees.
- Support research to promote clinical knowledge, development, and research-based clinical practice.
- Participate in development of clinical policy and procedures to improve quality of care delivery.
- Evaluate current research findings for specialty and determine efficiency in practice setting.
- Provide care to patients and caregivers in efficient manner.
- Prescribe controlled and non-controlled medications, as indicated, to relieve pain and non-pain symptoms associated with the terminal illness.
- Participate in programs to maximize access to palliative care for eligible patients.
- Identify opportunities for improvement in services and work cooperatively with Medical Director to implement appropriate changes.
- Participate in other clinical/administrative responsibilities, as directed.
- Work cooperatively with the Medical Director to ensure quality care delivery to all Company patients.
- Provide leadership in the development, implementation, and evaluation of standards of practice within the hospice specialty.
- Assume responsibility as a self-directed professional for own continuing education. Identify needs or seek direction in identification of needs to maintain expertise and keep current with health care trends and nursing practices.
- Pursue own professional growth through attendance at appropriate Continuing Education and reading of relevant medical literature.
- Establish professional goals for self and continually evaluate self in the attainment of these goals.
- Perform other duties as assigned.
Additional ARNP Preceptor Responsibilities:
- Develop and utilize an orientation checklist for ARNPs’ first year of employment with the Company and present to the Medical Director for approval.
- Provide information and education to the ARNPs based on the orientation checklist.
- Serve as a mentor and role model for new ARNPs.
- Develop and update ARNP competency checklist that will be used annually and, as needed, in evaluating the ARNPs’ performance.
- Explain their role and performance expectations to the new ARNPs.
- Assist the orientee to identify learning needs and provide prompt and consistent feedback, identifying areas in need of further development to the new ARNP and the Medical Director.
- Plan, coordinate, and carry out or suggest educational opportunities for the new ARNPs in conjunction with the Medical Director.
- Regularly assess clinical skills of new ARNPs over the first year of their employment with the Company.
- Regularly audit new ARNPs’ documentation of patient visits for accuracy and completeness.
- Meet regularly, approximately monthly, to review progress and provide ongoing feedback to new ARNPs.
- Maintain records documenting each meeting with ARNPs and specific assessments of their progress, recommendations for improvement, and areas still in need of further improvement.
- Provide written report monthly to Medical Director regarding the progress of new ARNPs.
- Identify program issues to the Medical Director that may be helping or hindering new ARNPs’ learning and on-boarding success.