Contracted Pediatric Physician

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This position provides support remotely with occasional patient visits in service area.

The Hospice and Palliative Medicine (HPM) Physician is a member of the Active Medical Staff of
Capital Caring Health and provides services to our patients throughout our continuum of care. This
continuum includes but is not limited to: home and facility-based hospice; home and facility-based
palliative care; inpatient hospice; hospital-based palliative care consultation; and outpatient palliative
care clinics.

HOSPICE MEDICINE:
When the Hospice and Palliative Medicine physician functions within the hospice environment, s/he
serves as a part of the assigned hospice interdisciplinary team/group (IDT/IDG) as the Hospice
Medical Director (HMD). The HMD assumes overall responsibility for the medical component of the
hospice’s patient care. S/he shares with other members of the medical staff the responsibility for
quality of care provided to patients receiving Capital Caring Health Hospice Services.
Specific hospice-related services provided by the Hospice and Palliative Medicine Physician include:
1) Palliation and management of terminal illness, 2) Medical care interventions targeting unmet
general medical needs, and 3) hospice pre-election evaluation and counseling services.

Specifically, the HMD or physician designee (as required by Medicare’s Conditions of Participation):
a. Collaborates with the IDT/IDG to ensure that the medical needs of the patient are met
and providing oversight of the plan of care

b. Certifies that the patient meets the eligibility criteria for hospice care based upon
available diagnosis and prognostic indicators; determines related diagnosis(es) if any;
current subjective and objective medical findings, current medication and treatment
orders; and reviews information about the medical management of any of the patient’s
conditions unrelated to the terminal illness.

c. Collaborates with the patient's attending physician to develop and update the patient's
plan of care, to identify needs not met by the attending physician, to ensure the most
cost-effective regimen for pain and symptom management. The HMD may also
determine, in consultation with the patient’s physician and authorized decision maker,
when a patient can no longer remain at home and should be moved to a congregate
living facility of the patient’s choosing.

PALLIATIVE MEDICINE:
When the Hospice and Palliative Medicine physician functions within the Palliative Care
environment, s/he serves in a consultative role for hospitalized and/or outpatients with Palliative Care
needs. The Hospice and Palliative Medicine physician is part of the assigned interdisciplinary
team/group (IDT/IDG) for each palliative care patient and coordinates the Palliative Medicine plan of
care in conjunction with the patient’s attending physician and other consultants. S/he shares with other
members of the medical staff the responsibility for quality of care provided to patients receiving
Capital Caring Health Palliative Care Services.

Specific Palliative Medicine-related services provided by the Hospice and Palliative Medicine
Physician include:
1) Palliation and consultative management of chronic, progressive (usually
terminal) illness, and
2) Hospice pre-election evaluation and counseling services.

The Palliative Medicine consultant:
a. Collaborates with the IDT/IDG to ensure that the medical needs of the patient are met
and providing oversight of the plan of care
b. Collaborates with the patient's attending physician to develop an update the patient's
plan of care, to identify palliative medicine needs not met by the attending physician,
and to insure pain and symptom management and control.

Experience Requirements

The HPM Physician must have at least 3 years of related experience. A Palliative Care Fellowship is also preferred. Expertise in the medical care of terminally ill individuals is required.

Education Requirements:

The HPM Physician must have a MD or DO from an accredited institution. The HPM Physician must also be board certified in an American Board of Medical Specialties (ABME) certified medical specialty with current recertification and be ABME Board Certified in Hospice and Palliative Medicine with current recertification

Required Certifications and/or Licenses:

The HPM Physician must have medical practice licensure from the governing body for medical practice for the District of Columbia, State of Maryland, and/or the Commonwealth of Virginia. DEA and State Controlled Substances Registration in above jurisdictions is required.

Quality Provision of Services:

1. Provides medical management across all care settings within Capital Caring Health at the direction of the General Manager with support from the Neighborhood Lead Physician. (H/PC)

2. Effectively complements attending physician care. (H/PC)

3. Acts as a medical resource person to the IDT/IDG. (H/PC)

4. Assures overall continuity medical services provided to hospice patients. (H)

5. Assures that the patient receives appropriate measures to control uncomfortable symptoms. (H/PC)

6. Serves as a medical resource to Capital Caring Health staff, patients, families, and attending physicians regarding pain and symptom control management. (H/PC)

7. Ensures the provision of direct medical services to patients either directly or through arrangement, as appropriate, in the absence of the patient's attending physician. (H)

8. Attends IDT/IDG conferences. Actively participates in the interdisciplinary team/group meetings as assigned, Arranges for alternative physician coverage if unable to be present for the entire meeting. (H)

9. Participates in the plan of care development and managing oversight of medications and treatment. (H/PC)

10. Documents care provided in the patient's clinical record providing evidence of progression of the end-stage-disease process. (H)

11. Provides triage, after hours, and weekend coverage for region and hospice inpatients within the context of the Capital Caring Health after hours and weekend coverage system. (H/PC)

12. Provides palliative medicine consultation for pain and symptom management for non-hospice patients, as requested by attending physicians, in home, hospital, or long-term care settings. (PC)

13. Consults with representatives of the IDT/G. If necessary, amends the plan of care and initiates appropriate therapy to ensure that the medical care/plan of care is consistent with appropriate palliative care. (H/PC)

14. Is readily available for hospice visits for patients needing a palliative medicine consultation to guide care, as determined collaboratively by the hospice medical director, the interdisciplinary team, and/or the attending physician. (H/PC)

15. Acts as a liaison to physicians in the community. (H/PC)

16. Assumes Attending Physician responsibility for patients when needed to assure 24-hour physician coverage of all patients receiving Capital Caring Health Services. (H)

17. Educates and develops relationships with referral sources. (H/PC)

18. Participates in collaborative research projects as possible. (H/PC)

Organizational/Regulatory Compliance:

1. Re-certify patients, as appropriate, for continuation of Medicare Hospice benefit at appropriate levels of care. Adheres to best practices using the Capital Caring Health clinical algorithms. Signs certifications, re-certifications, orders, and completes documentation within specified time frames. Prepares thorough and complete documentation of any and all clinical encounters to support charges. (H)

2. Maintains current knowledge of the latest research and trends in Hospice and Palliative Medicine, particularly in regard to pain/symptom management. Maintains continuing education as required for licensure and to insure specialty level expertise in end-of-life care. Must attend at least one hospice/palliative care educational program per year and have a professional development plan for passing the (ABMS Hospice and Palliative Medicine) certification exam within 24 months of employment (or other appropriate competence evaluation). (H/PC)

3. Participates in QAPI activities as needed, including regular medical record reviews and medical peer review. Seeks to continually improve the care practices of Capital Caring Health to assure compliance with regulatory and accreditation standards. (H/PC)

4. Completes all facility and payer credentialing in a timely fashion – not more than two (2) weeks after receipt.

5. Documents in appropriate chart and forms in an accurate and timely manner to provide a written record of assessments, plans of care, and to assure the availability of information to team members

6. Reviews and develops protocols for treatment and proposing the most current options for interventions. (H/PC)

7. Participates in resolution of interpersonal conflict and issues of clinical and ethical concern. (H/PC)

8. Participates in development and updating of patient care policies and emergency procedures when requested. (H/PC)

People/Communications:

1. Participates in medical staff activities including weekly fellow teaching and related activities. (H/PC)

2. Demonstrates knowledge in communications and counseling patient/family in dealing with end-of-life issues. (H/PC)

3. Encourages and models coordination and communication with the patient’s attending physician. Helps to keep the team mindful of the importance of customer service with regard to the attending physician and other referral sources. Demonstrates high “consultant etiquette” by a willingness to call attending physicians to discuss patient matters. (H/PC)

4. Demonstrates commitment to educate and increase knowledge and skill level of staff, trainees or visitors in caring for chronically ill/ terminally ill patients and their families. Emphasizes the importance of each individual team member. Participates in the supervision of all trainees to optimize their educational experience in Hospice and Palliative Medicine. (H/PC)

5. Participates in performance improvement programs, as indicated. (H/PC)

6. Works in a team approach with the IDT/IDG. (H/PC)

7. Provides consultation and education to colleagues and attending physicians related to admission criteria for hospice and palliative care. Is available for consultation by members of the IDT/G between 8:00 a.m. and 5:00 p.m. Monday through Friday and urgently as needed.

8. With the GM, GO Team/Care Reps, and other stakeholders, promotes Capital Caring Health in hospice and palliative care concepts in the medical community in order to:

a. Ensure collaborative relationships with the medical community

b. Continuously improve relationships between Capital Caring Health and the medical community

c. Stimulate referrals to Capital Caring Health

Financial Stewardship

1. Implements time-based billing procedures using the electronic medical record system software and other appropriate methods to capture timely billing (weekly for home and nursing home; daily for inpatient and clinic charges). Achieves expected productivity standards as defined by the organization and in alignment with best practices/the Capital Caring Health model. (H/PC)

The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.