Chief Medical Officer

June 28, 2019


Hospice of Santa Cruz County
Santa Cruz, CA, United States


Job Summary:
The Chief Medical Officer (CMO) is a licensed physician in the State of California who assumes overall responsibility for the medical component of the Hospice program and for the supervision, scheduling and oversight of the Hospice Medical Director staff, assesses appropriateness of admissions, certifies terminal prognosis and participates in establishing, reviewing and revising plans of care for Hospice patients that reflects pt/family goals related to Safe & Comfortable Dying, Self-Determined Life Closure and Effective Bereavement; leads development of clinical policy and participates in in-service education. Provides oversight to QAPI, including utilization review of physician role; acts as a medical resource/liaison to physicians and health care providers; and acts as a resource for and member of the Interdisciplinary Group (IDG). The position is carried out in a manner that demonstrates 1) clinical competence and leadership in hospice palliative care 2) sensitivity and compassion to issues involved with serving patients and families facing a terminal illness, death and bereavement, and 3)fiscal responsibility in the planning and delivery of services.

Essential Responsibilities

Specific Functional Responsibilities
CMO shall perform those services appropriate to the position of medical director of a hospice, which includes, but is not limited to, the following administrative services
• Interview and participate in the recruitment, hiring and contracting of medical directors with the Chief Clinical Officer.
• Provide/oversee orientation of new physician staff regarding their responsibilities, principles of palliative medicine and hospice guidelines and standards of care
• Evaluate the clinical competency and employee performance of all medical directors on an annual basis
• Ensure that medical directors are caring for patient’s appropriately, based on established hospice guidelines and standards
• Ensure that medical directors are providing visits to patients based on patient need and as determined by the comprehensive plan of care
• Ensure proper physician participation and support in IDG meetings and proper physician support to the nurse, team leader, patient care manager and other clinical team members
• Ensure medical directors serve as palliative medicine resources for hospice staff and for attending and referring physicians
• Maintain on call schedule to ensure trained on call Medical Director coverage 24 hours a day, 7 days a week. Coverage means being available through direct telecommunication for consultation, assistance with medical emergencies requiring GIP and patient referral
• Performs other related job duties as assigned by Supervisor

Education and Research
• Attend appropriate orientation and in service training programs
• Remain current on issues related to a hospice medical practice
• Conduct periodic in service training programs for Hospice staff and volunteers, as requested by Hospice
• Participate in professional organizations related to hospice and palliative medicine
• Participate in any hospice or palliative care research, as requested by Hospice

Community Relations
• Develop strategies to build relationships with hospitals, including GIP and other palliative care program development.
• Develop strategies to build relationships with local physicians, which shall include educating physicians on the principles of hospice and palliative medicine, Hospice's services and its medical policies and procedures
• Collaborate with SNF medical directors to ensure that hospice clinical guidelines, policies and standards are compatible with SNF clinical guidelines, policies and standards and to ensure that patients under the joint care of hospice and SNF receive care based on an agreed-upon, coordinated plan of care. Ensure Medical Director participation in SNF education
• Ensure medical directors serve as liaisons between hospice and community physicians

Patient Care Services
• Assume the overall responsibility for the medical component of the Hospice's patient care program.
• In addition to palliation and management of the terminal illness and related conditions, meets the general needs of the patients to the extent that these needs are not met by the attending physician.
• In consultation with patient's attending physician, if any, recommend admissions into Hospice considering patient's diagnoses, other health conditions whether related or unrelated to the terminal condition and current clinically relevant information supporting all diagnoses, and certify and document a patient's terminal illness.
• Ensure that a medical director is a member of Hospice's interdisciplinary team ("IDT"), to certify and recertify patient eligibility for hospice care, and meet with the other members of the IDT to develop, periodically review and update a written plan of care for each Hospice patient. Ensure that the hospice plans of care are medically appropriate and consistent with federal and state laws and regulations.
• Attend and actively participate in interdisciplinary team meetings providing education and oversight of assigned team. Utilizes clinical judgment to assess and recertify patient prognosis at appropriate intervals. CMO may request additional assessment data, make patient visits and collaborate with Attending Physician as needed.
• Ensure medical direction is provided for patients utilizing pain and symptom management interventions that are based on hospice established guidelines and standards.
• Discharge those patients no longer eligible for hospice care, in consultation with the patient's attending physician, if any, and consistent with federal and state discharge requirements and Hospice's discharge policies.
• Provide any other medical services that may be necessary to comply with any federal or state laws or regulations governing hospice care.
• Ensure medical management for those patients admitted to Hospice who have no attending physician, as requested by Hospice
• Provide hospice consultations, as requested by Hospice pursuant to the attending physician’s order and the hospice plan of care.
• Medicare Hospice regulations require that Hospice bill directly for treatment the Medical Director provides to Medicare Hospice patients, if the treatment is related to the terminal illness.
• Ensures all HIPAA Privacy and Security Regulations, Medicare Conditions of Participation, and all other regulatory/compliance requirements are understood and followed
• Ensures compliance with all job related State/Federal Laws
• Models compliance and educates staff as necessary

Supervisory Responsibility
• Supervision of Other Hospice Physicians (Medical Directors and Associate Medical Directors)

• Experience in the care of terminally ill patients—at least 2 years experience in a medical specialty dealing with terminally ill patients, such as oncology or geriatrics, and with demonstrated experience in the principles of pain and symptom management

Skills Required
• Chief Medical Officer is and shall remain duly licensed to practice medicine without restriction in the State of California and shall maintain proof of current licensure on hospice files.
• Comply with the ethics and professional standards of the medical profession; applicable federal, state and local laws, rules and regulations; Hospice's policies and procedures; and the rules and regulations that are applicable to Hospice, including accreditation and certification requirements.
• Maintain registration with the Drug Enforcement Administration ("DEA") and any applicable state agency without any limitation on CMOs authority to prescribe drugs under such registration and shall maintain current proof of such registration upon Hospice's request.
• Shall remain at all times a qualified Medicare and Medicaid provider. Represents and warrants that he or she has never been excluded from participation in any federally funded health care program including, without limitation, Medicare, Medicaid or TRICARE, nor has been convicted or found to have violated any federal or state fraud and abuse law or illegal remuneration law.
• CMO shall maintain unrestricted medical staff membership and clinical admitting privileges at the hospitals with which Hospice has a contract.
• CMO shall at all times qualify for insurance coverage under Hospice's professional liability policy.
Certifications, Licenses, Registrations
• Board Certified (by American Board of Medical Specialties-ABMS) doctor of medicine or osteopathy licensed to practice medicine in the State of California.
• Board Certified in Hospice and Palliative Care
• Pass OIG/GSA review and all required background checks


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