Nurse Practitioner

Visiting Nurse Association of Franklin•Franklin, NH

6d•Onsite

About The Position

This is an in-person, full-time Nurse Practitioner position providing advanced clinical care to hospice patients in coordination with the Hospice Medical Director and in accordance with Medicare Hospice Conditions of Participation. The NP manages symptoms, provides palliative care, and supports terminally ill patients and their families through the end-of-life process. The role supports regulatory compliance through Face-to-Face encounters for hospice recertification, interdisciplinary collaboration, and accurate, timely documentation of hospice eligibility and care. The NP is expected to demonstrate alignment with the hospice’s nonprofit, mission-driven values by providing compassionate, culturally sensitive, community-centered care; building trust with patients, families, and community partners; and advocating for patient dignity, comfort, and equitable access to hospice services. The position involves home and residential visits throughout central New Hampshire, participation in interdisciplinary meetings every two weeks on Wednesday, and on-call coverage for symptom management and medication approvals.

Requirements

Current, unrestricted Nurse Practitioner license for the applicable state.
Board certification as an FNP, ANP, AGNP, or equivalent.
Active DEA license and prescriptive authority.
Minimum of 2 years of clinical experience.
Knowledge of the Medicare Hospice Benefit and CMS Conditions of Participation.
Knowledge of end-of-life disease trajectories and prognostication.
Expertise in advanced symptom management and palliative care.
Clinical autonomy with collaborative practice.
Strong hospice regulatory knowledge.
Exceptional communication skills in sensitive situations.
Ability to manage diverse responsibilities across the care continuum.
Ability to work independently without immediate supervision.
Excellent patient care skills and strong knowledge of nursing and health care terminology.
Compassionate and empathic manner with patients and family members.
Ability to work as part of a team and maintain positive relationships with employees and healthcare professionals.
Strong verbal and written communication skills.
Ability to document patient care according to nursing standards and the plan of care.
Ethical conduct and ability to build trust with patients and family members.
Ability to follow agency safety guidelines and wear protective clothing as needed.
Ability to travel throughout central New Hampshire.
Current driver's license, proof of automobile insurance, and ability to pass a motor vehicle background screening.
Ability to perform the physical activities required, including sitting or standing for extended periods; typing; reaching; walking; kneeling; lifting; fingering; grasping; feeling; talking; and hearing.
Ability to exert up to 20 pounds of force occasionally and 10 pounds regularly.
Visual acuity sufficient to see at or within arm’s reach and operate a motor vehicle.

Nice To Haves

Experience in hospice, palliative care, geriatrics, or oncology is strongly preferred.

Responsibilities

Perform comprehensive assessments of hospice patients in home and residential settings.
Assist with hospice admissions by evaluating clinical eligibility and conducting initial medication reviews.
Act as the Attending Physician when chosen.
Manage pain and complex symptoms, including dyspnea, agitation, delirium, and nausea.
Develop and revise individualized plans of care in collaboration with the hospice physician.
Order and prescribe medications, durable medical equipment, and treatments in accordance with 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.
Provide on-call coverage for symptom management and medication approvals.
Conduct and document Face-to-Face encounters for patients entering their third benefit period (day 180) and beyond, in compliance with CMS requirements.
Provide clinical findings to assist the hospice physician with certification and 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 with chart audits, clinical reviews, and compliance initiatives.
Participate in Interdisciplinary Group meetings every two 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, such as hospital-to-hospice transitions, home placement, and imminent death.