Medical Director- Hospice

Job description

PRIMARY FUNCTION
The Medical Director shall be a physician licensed to practice medicine in the state where the hospice is located. In his/her absence, the medical director shall designate another physician to serve as acting medical director.
The Medical Director of VITAS fulfills two primary functions, each of which is expected to consume approximately one half of the time and work effort of the position:
• A. The Medical Director has overall responsibility for medical direction of the care and treatment of patients and their families rendered by the hospice care team, and shall consult and cooperate with the patient’s attending physician. The Medical Director provides physician direction and guidance to the hospice program, its physician employees, and other staff and volunteers to assure the maintenance of quality standards of care for patients and families.
• B. The Medical Director educates practicing physicians and others engaged in health care services regarding the hospice program and its potential benefits to patients.

In fulfilling the two primary functions explained above, the medical director performs the following duties:
I. Quality of Clinical Care
• a. Assure appropriate evaluation and certification of terminal prognosis of patients
• b. Assure the quality of initial plans of care.
• c. Assure the quality of comprehensive plans of care.
• d. Assure the accuracy of documentation.
• e. Review revocations.
• f. Review recertifications of terminal prognosis.
• g. Review the quality of pain and symptom management.
• h. Provide medical expertise on pain and symptom management to admission and patient care staff.
• i. Provide medical expertise on the evaluation of terminal prognosis to admission and patient care staff.
• j. Actively participate in formal Quality Improvement functions and committees.
• k. Actively participate in Interdisciplinary Group, as applicable.
• l. Actively participate in Program’s Ethics Committee.
• m. Interact with attending physicians as necessary regarding pain and symptom management issues and issues involving patient prognosis.
• n. Coordinate with attending physicians to assure a continuum of medical care in cases of emergency or in the event the attending physician is unable to retain responsibility for a patient’s care.
• o. Participates in an on-call schedule to provide 24 hours a day, 7 days a week coverage of hospice physician services.
• p. Conduct discussions with patients and families, at the request of program management.
• q. Periodically attend home care team meetings and rounds in inpatient units.

II. Supervision of Physicians
• a. Interview and participate in the hiring and contracting of physicians and nurse practitioners.
• b. Orient physicians and nurse practitioners as to clinical responsibilities and the principles of palliative medicine.
• c. Periodically review the quality of clinical care provided by the physicians and nurse practitioners.
• d. Periodically review the quality of the documentation of visits made by the physicians and nurse practitioners.
• e. Assure that documentation of visits supports the CPT coded level of service billed.
• f. Ensure proper physician and nurse practitioner participation and support in team meetings.
• g. Ensure proper physician and nurse practitioner support to the VITAS nurse, team manager, and other team members.
• h. Ensure adherence to the VITAS Compliance Policy and Code of Ethical and Legal Conduct (Policy 1:04) for program physicians and nurse practitioners.
• i. Participate in the yearly formal evaluation of the physicians and nurse practitioner.
• j. Ensure that a physician on-call rotation is established so that there is physician support available 24 hours a day, 7 days a week.

III. Management
• a. Participate as an active member of the local management team (includes budget process, strategic planning, etc.).
• b. Collaborate with program management in assuring compliance with policies, procedure, standards, Federal, State and local regulations by program physicians and nurse practitioners.
• c. Actively participate in responding to audits and denials from third party insurance and intermediaries (i.e. Medicare).
• d. Ensure that all contracted physicians (employee physicians and consulting physicians) are properly credentialed via the VITAS Credentialing process.
• e. Participates with program management in monitoring and appropriate clinical utilization of pharmaceuticals and other ancillary supplies.

f. Supervise the following functions of the pharmacy
• i. Ensure that medications are utilized within acceptable standards of practice
• ii. Ensure that a system is developed and maintained to document the disposal of controlled drugs.

IV. Community Relations
• a. Educate community physicians on the principles of palliative medicine.
• b. Provide resource and consultative support to community physicians in hospice and palliative medicine.
• c. Attend and present at medical staff and other medical community conferences on hospice and palliative medicine.
• d. Serve as liaison between the hospice and community physicians.
• e. Make regular contacts with practicing physicians to introduce the hospice program, to educate physicians regarding individuals for whom hospice may be appropriate, and to answer clinical and other concerns of physicians with respect to hospice.
• f. Assist in introducing the VITAS program to long term care providers, managed care providers, hospitals, and others.
• g. Conduct educational seminars, in services, and presentations to physicians, nurses, and other health care audiences whose support for and understanding of the hospice program is integral to assuring that hospice services are made accessible to patients and families.

V. Education
• a. Complete Medical Director and Physician orientation training modules, and complete Vitas Annual Update.
• b. Assist in the development of and actively participate in clinical training for all hospice patient care, admissions and administrative personnel.
• c. Actively participate in medical and nursing education programs on palliative medicine that may be provided by VITAS to medical and nursing colleges in the community.
• d. Assist, as required, in the development and implementation of research protocols on both the local and corporate level.
• e. Be a member of and participate in professional organizations related to palliative medicine.

VI. Other
• a. Other duties, as assigned by the general manager, including performing the duties of a team physician when necessary.

ESSENTIAL REQUIREMENTS
The following specific requirements are considered essential for an individual to fulfill the functions and duties of this position:
• Knowledge of the principles and practice of primary medical care, with at least a working knowledge of principles of palliative medicine and symptom management.
• Ability to work collaboratively with patients’ attending physicians to implement the hospice program and effect optimum medical care.
• Ability to work collaboratively with hospice employees and volunteers as part of an interdisciplinary team.

PRE-EMPLOYMENT REQUIREMENTS FOR THIS POSITION
• Graduate of an accredited school of medicine or osteopathy with current license to practice medicine in the state in which the Program is operating.
• Board eligible/certified in a medical specialty which deals with care of the terminally ill, such as Hospice and Palliative Medicine, Internal Medicine, Oncology or Family Practice, with at least a working knowledge of medical oncology and demonstrated expertise in the principles of palliative medicine and symptom management.
• If Medical Director will be providing inpatient care, membership in good standing on the medical staff of the hospital or hospitals in which the hospice inpatient care is provided.
• Registration with the Drug Enforcement Agency (DEA) to prescribe all schedules of controlled substances with no restriction as to the location of practice.
• If applicable, state controlled substance certification or registration for the state in which the hospice program is operating.
• Enrollment with the Provider Enrollment, Chain and Ownership System (PECOS) to, at a minimum, be able to order and refer through other Medicare-certified providers.
• Completion of designated application and verification of credentials and qualifications.
• Equivalent experience or licensure may be considered.

ADDITIONAL REQUIREMENTS FOR CALIFORNIA MEDICAL DIRECTORS
In accordance with California Code of Regulations Title 22, Section 74856 Medical Directors:
• (a) The Hospice Governing Body must appoint the Medical Director in writing.
• (b) The Medical Director must qualify for the position by meeting all of the following requirements:

• The Medical Director must possess a current and valid license as a physician and surgeon issued by the Board of California or by the Osteopathic Medical Board of California.
• The Medical Director must have a minimum of two years of full-time supervisory or managerial experience in hospice, home health agency, or providing palliative care to patients within the last five years.

Note: A California Medical Director may manage only one hospice program.
REASONABLE ACCOMMODATIONS
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.
REPORTING RELATIONSHIP
The Medical Director reports to the General Manager of the hospice.
I hereby agree to fulfill this position with my best efforts, having read and understood the foregoing job description.
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