Nurse Practitioner

Visiting Nurse Association of Franklin•Franklin, NH

1d•Onsite

About The Position

The Nurse Practitioner (NP) would work in coordination with the Hospice Medical Director, providing advanced clinical care to hospice patients in accordance with Medicare Hospice Conditions of Participation. The NP is responsible for symptom management, Palliative Care, and supporting the terminally ill patient and family through the end-of-life process. The NP plays a key role in regulatory compliance, including Face-to-Face (F2F) encounters for hospice recertification, interdisciplinary collaboration, and ensuring accurate, timely documentation to support hospice eligibility and care. The NP must demonstrate strong alignment with the hospice’s nonprofit, mission-driven values. Provide compassionate, culturally sensitive, and community-centered care. Build trust with patients, families, and community partners. Advocate for patient dignity, comfort, and equitable access to hospice services.

Requirements

Current, unrestricted Nurse Practitioner license (state-specific).
Board certification (FNP, ANP, AGNP, or equivalent).
Active DEA license and prescriptive authority.
Minimum 2 years of clinical experience; hospice, palliative care, geriatrics, or oncology strongly preferred.
Knowledge of: Medicare Hospice Benefit, CMS Conditions of Participation (CoPs), End-of-life disease trajectories and prognostication.
Advanced symptom management and palliative care expertise
Clinical autonomy with collaborative practice
Strong hospice regulatory knowledge
Exceptional communication in sensitive situations
Ability to manage diverse responsibilities across care continuum
Compassionate, mission-driven approach
Ability to work independently and without immediate supervision.
Excellent patient care skills.
Strong knowledge of nursing and health care terminology.
Ability to demonstrate a caring, compassionate and empathic manner with patients and family members.
Ability to work as a team and maintain positive working relationships with employees and healthcare professionals.
Strong verbal and written communication skills.
Ability to document patient care according to nursing standards and plan of care.
Must demonstrate ethical conduct and build trust with patients and family members.
Ability to follow safety guidelines as instructed by the agency.
Ability to wear protective clothing such as mask, glove, head cover, lead apron, safety glasses, safety shoes, etc.
Ability to travel required. Travel throughout central New Hampshire is required.
Current drivers’ license is required.
Proof of automobile insurance is required.
Ability to pass a motor vehicle background screening is required.

Responsibilities

Perform comprehensive assessments of hospice patients in home and residential settings.
Assist with hospice admissions by evaluating clinical eligibility and initial med reviews.
Act as the Attending Physician when chosen.
Manage pain and complex symptoms (e.g., dyspnea, agitation, delirium, nausea).
Develop and revise individualized plans of care in collaboration with the hospice physician.
Order and prescribe medications, durable medical equipment (DME), and treatments per state scope of practice and hospice policies.
Respond to acute changes in condition, including urgent or same-day visits as needed.
Approve medications in Scriptsure.
Cover on call coverage for symptom management and approval of meds.
Conduct Face-to-Face (F2F) encounters for patients entering their third benefit period (day 180) and beyond, in compliance with CMS requirements: Perform and document eligibility assessments supporting a prognosis of =6 months if the disease runs its normal course. Provide clinical findings to assist the hospice physician in certification/recertification decisions.
Ensure documentation supports: Terminal prognosis, Ongoing eligibility and Skilled need for hospice services.
Identify when patients no longer meet hospice criteria and assist with discharge planning.
Participate in QAPI and state surveys as needed.
Assist in chart audits, clinical reviews, and compliance initiatives.
Actively participate in Interdisciplinary Group (IDG) meetings every 2 weeks on Wednesday.
Collaborate with RN case managers, social workers, chaplains, aides, and volunteers.
Provide clinical guidance to team members regarding symptom management and care priorities.
Facilitate goals-of-care conversations, advance care planning, and code status discussions.
Educate patients and families about disease progression and hospice philosophy.
Provide compassionate support during the end-of-life process, including active dying.
Assist with transitions (e.g., hospital to hospice, home placement, imminent death).