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ST. CHARLES MEDICAL GROUP

PHYSICIAN JOB DESCRIPTION

TITLE: SCMG Physician - Hospice and Palliative Care

REPORTS TO POSITION: Chief Medical Officer

DEPARTMENT: Post Acute Care, Hospice and Palliative Care

DATE LAST REVIEWED: February 10, 2022

OUR VISION: Creating America's healthiest community, together

OUR MISSION: In the spirit of love and compassion, better health, better care, better value

OUR VALUES: Accountability, Caring and Teamwork

POSITION OVERVIEW: Hospice Physician works as a member of the interdisciplinary care team to provide comprehensive hospice services. The hospice physician role for the team is to provide palliation and symptom management of the terminal condition. The hospice physician provides evaluation and assessment of the health history and medical conditions to determine the eligibility and ineligibility of patients referred for hospice services. Provides initial and ongoing certification of the terminal illness. Collaborates with patient, families, and the interdisciplinary team to develop the plan of care. The hospice physician will visit patients, manage symptoms, complete physical assessments, perform face-to-face assessments, and determine hospice eligibility. The hospice physician collaborates with the patient's attending and other physicians and providers as needed to maintain an effective continuum plan of care.

Palliative Care Physician works as a member of the interdisciplinary palliative care team to provide inpatient and outpatient palliative care consultations at St. Charles Health System. The physician role for the team is to provide advanced clinical expertise including prognostication, symptom management and assist with clarification of patient and family centered goals for medical care, as well as support for the advance practice nurses on the team in providing medical and symptom management. Will work collaboratively in the inpatient and outpatient settings with the palliative care team and all members of the patient's medical care team to provide high quality patient and family centered care.

HOSPICE WORK SCHEDULE: Hospice clinic business hours 8 am to 430 Monday through Friday. Covering IDT (required interdisciplinary team meetings for the South and North Teams) on Wednesday and Thursday scheduled times.

HOSPICE CALL EXPECTATION: After hour clinic call (4:30 pm to 8 am Monday to Thursday) will be shared equally by privileged providers within service line. Weekend coverage rotation currently scheduled and shared with other providers for a 1:4 weekend ratio (Weekend coverage 4:30 pm Friday to 8 am Monday)

HOSPICE WORK LOCATION(S): Primary work location will be St. Charles Hospice Bend and Prineville offices with patient visits scheduled within the coverage area. (Coverage of additional work locations may be requested as needed)

PALLIATIVE CARE WORK SCHEDULE: Patient care in inpatient and outpatient settings providing consultations as requested and scheduled, availability expected between 7am-6pm with after hours and weekend call coverage by phone shared equitably among privileged providers within service line.

PALLIATIVE CARE WORK LOCATIONS: Primarily Bend and Redmond St. Charles Campuses, but can include locations throughout Central Oregon, which will be arranged for provider efficiency to every extent possible, including via telemedicine.

DEPARTMENT SUMMARY: St. Charles Hospice provides end of life care services to patients and their families. Hospice addresses the physical, emotional, and spiritual needs of patient and family from admission through bereavement utilizing an interdisciplinary approach to care that includes physicians, nurse practitioners, registered nurses, chaplains, aide's, social workers, volunteers and counselors.

The St. Charles Advanced Illness Management Palliative Care Program is an interdisciplinary team including physician, nursing, social work, and spiritual care providers, working collaboratively to provide consultative services at St. Charles Health System hospitals and clinics and other locations within the Central Oregon area. The Palliative Care team endeavors to provide high level communication and compassion as well as expert symptom management, emotional and spiritual and psychosocial support for patients and their families coping with serious, life-limiting illness

ESSENTIAL FUNCTIONS AND DUTIES

Clinical Responsibilities:

• In collaboration with the patient's attending physician, is responsible for the palliation and management of the patient's terminal illness and conditions related to the terminal illness for assigned patients.

• Attends IDT and collaborates with the Hospice Team to ensure that the medical needs of the patient are met and provides oversight of the plan of care.

• Renders the necessary medical management, in consultation with the patient's attending physician, consistent with the plan of care and the patient's needs.

• Serves as a medical resource to hospice staff, patients, families and attending physicians regarding pain and symptom management.

• Ensures provision of direct medical services to patients, in the absence of the patient's attending physician.

• Performs home visits and visits for inpatient hospice services related to patient assessment and care as needed and appropriate.

• Participates in resolution of interpersonal conflict and issues for clinical and ethical concerns.

• Demonstrates care provided in the medical record providing evidence of progression of the end-stage disease process.

• Provides Pre-hospice election Evaluation and Counseling services.

• Reviews patient's clinical information before certifying and recertifying terminal illness and provides written certification.

• Completes and/or ensures Face-to-Face visits are completed and documented prior to recertifying hospice patients.

• Ensures physician and nurse practitioner documentation, billing and coding practices are met per established standards.

• Upon admission, completes medication reviews to determine hospice appropriate medications. Prescribes medications needed for patient comfort.

• Participates in and reviews Additional Documentation Requests from Medicare when requested.

• Participates in the on-call physician rotation to support hospice patient care with physician coverage being available 24 hour per day, seven days per week.

• Participates in reviewing and maintains current knowledge in latest research and trends in hospice care.

• Attends and participates in hospice team in-services and education programs.

• Works collaboratively in team approach with hospice staff to achieve strategic goals.

• Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies, and procedures, supporting the health system's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violations of applicable rules, and cooperating fully with all company investigations and proceedings.

• Ensures consistent clinical and technical excellence and superior customer services. Delivers customer services and/or patient care in a manner that promotes goodwill, is timely, efficient, and accurate.

• Meet productivity standards supportive of organizational goals.

• Guidance to hospice NP or nurse as they provide direct patient care

• Participates in QAPI and process improvement as needed.

• Provide inpatient and outpatient consultation services in palliative care.

• Facilitate clarification of patient and family goals of care and communicate those goals to involved health care team.

• Consult with the attending physician and the Interdisciplinary Team and involved ancillary staff to establish a written plan of care at intervals specified in the plan.

• Facilitate access to appropriate supportive care services.

• Education of staff and coworkers about palliative care.

• Full and appropriate documentation of patient care services to support professional billing for these services.

• Participation in on-call coverage with the physician and nurse practitioner team.

• Regular participation in interdisciplinary team meetings to review active cases and program development.

• Assist in the development of standards of care.

• Adhere to the practice of confidentiality regarding patients, families, staff, and the organization.

• Serves as a medical resource to hospice and palliative care teams, patients, families and attending physicians regarding pain and symptom management for patients with advanced illnesses.

• Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies, and procedures, supporting the health system's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violations of applicable rules, and cooperating fully with all company investigations and proceedings.

• Ensures consistent clinical and technical excellence and superior customer services. Delivers customer services and/or patient care in a manner that promotes goodwill, is timely, efficient, and accurate.

• Meet productivity standards supportive of organizational goals.

Non-Clinical Responsibilities:

• Be familiar with the SCMG organization structure, communications systems and billing process, completing billing and coding documentation within time assigned by SCMG administration.

• Keep all licenses and appropriate certifications current and unrestricted.

• Maintain active privileges at a St. Charles Health System hospital sufficient to permit performance of job duties.

• Increase understanding and collaboration throughout the medical community regarding provider's chosen specialty.

• May perform additional duties of similar complexity within the organization, as required or assigned.

Essential Functions:

• Acts as a leader and supports departmental goals and the vision, mission, and values of the St. Charles Health System in all respects

• Provides customer service in a manner that promotes goodwill, is timely, efficient, and accurate.

• Creates a healing environment that supports all aspects of care, respects the wholeness of the individual, and demonstrates therapeutic presence through attitudes and behaviors that enhance the safety and care experience for patients, caregivers, and guests

• Supports Value Improvement Practice (VIP- Lean) principles of continuous improvement with energy and enthusiasm, functioning as a champion of change; Contributes as necessary to assist in policy formation for the organization

• Participates in creating intentional relationships with a high level of focus on attitudes and behaviors that enhance the care experience.

• Is familiar with the organization structure, communications systems and billing process, completing billing and coding documentation within time assigned

• Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies and procedures, supporting the health system's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violations of applicable rules, and cooperating fully with all health system's investigations and proceedings.

• Keep all licenses and appropriate certifications current and unrestricted to maintain privileges at a St. Charles Health System hospital sufficient to permit performance of job duties

• Increases understanding and collaboration throughout the medical community

• Maintain compliance of hospital's Medical Staff Bylaws, Rules and Regulations, as required by SCHS Board of Directors

EDUCATION

Required:

• Board Certification or Eligibility in Hospice and Palliative Medicine.

• Graduation from an accredited medical school.

• Successful completion of an accredited residency program in Physician's chosen specialty (ies).

• Successful completion of additional educational programs necessary to enable Physician to acquire and maintain privileges to perform the range of services contemplated. This includes board eligibility/certification in the specialty being practiced.

• Complete annual fire/safety, etc. education in-services as required.

• Attend mandatory educational offerings as described in SCHS policies/procedures and/or as required by other regulatory bodies.

• Complete annual CME as required to maintain license and appropriate Board certification.

• Complete in a timely manner assigned Computer Based Learning modules.

• Complete annual fire/safety, etc. education in-services as required

• Attends mandatory educational offerings as described in SCHS policies/procedures and/or as required by other regulatory bodies

• Complete annual CME as required to maintain license and appropriate Board certification

• Complete assigned Computer Based Learning modules in a timely manner

Preferred:

• Fellowship training in Hospice and Palliative Medicine

LICENSURE/CERTIFICATION/REGISTRATION

Required:

• Oregon license as MD / DO

• Board certified or eligible in Physician's chosen specialty. Those applicants who are not board certified at the time of application but who have completed their residency or fellowship training are required to become board certified within seven years of residency or fellowship training.

• Unrestricted Federal DEA number registered in Oregon

• Unrestricted ability to participate in Medicare / Medicaid, or other federal or state governmental health care programs.

• Valid driver's license and the ability to meet SCHS driving requirements.

• Current BLS certification required.

• If provider will practice sedation, moderate or deep, ACLS certification is also required.

• Additional certifications may be required based on privileges granted to provider by Medical Staff Services at SCHS Inpatient locations.

Preferred:

• Board Certification in Hospice and Palliative Medicine

EXPERIENCE

Required:

• Experience using EMR (Electronic Medical Records) software

• Advanced written and verbal communication skills to effectively interact with a diverse population and professionally represent St. Charles Health System

• Experience working in a team environment and proven ability to collaborate, manage facilitation and consensus building among health care professionals and agencies to achieve expected results.

Preferred:

• Prior medical experience in a hospice setting

• Epic EMR software experience

PERSONAL PROTECTIVE EQUIPMENT

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.