Detailed Information






The Hospice & Palliative Care NP will work autonomously but in collaboration with Physicians to provide primary medical care to patients with chronic or life limiting illnesses that require palliative or hospice care interventions. Reports to the Director of Hospice & Palliative Care.

The Nurse Practitioner will be responsible for rounding in hospitals and skilled nursing facilities, reviewing patients currently on services and updating care plans accordingly.  Under the direction of the medical director, the nurse practitioner will assess, review medication, create an appropriate care plan and provide and evaluate care. In addition, the nurse practitioner will assist with advanced directives and discuss goals of care and the disease process, progression, and grief process with patients and caregivers.

In addition, the Nurse Practitioner will work with the Director of Hospice & Palliative Care to provide education on palliative and hospice care within the community as well as the agency staff regularly.

Provides medical care and manages advanced illness in compliance with Rhode Island and Massachusetts Nurse Practice Act under the supervision of a collaborating physician in the home, hospital, or skilled nursing facility setting.



  • Complete Face to Face encounters and assess the following: disease related changes, decline in function, adherence and effectiveness of pain and symptom regimen, the patient and family coping mechanisms and quality of life.
  • Make referrals to other disciplines as indicated by the patient’s needs.
  • Actively participate in interdisciplinary team conferences and Palliative team conferences as needed meeting the needs of patients for palliation and managing of terminal illness and related conditions.
  • Performs Palliative care consultations to patients currently receiving home health care in partnering facilities and in the hospital setting. The NP will ensure the development and continued cultivation of positive referral relationships and access to hospice care.
  • Assess and treat symptoms to promote maximum level of wellness and independence for patients with terminal illness. Works in collaboration with nurses on complicated patients.  Facilitates family meetings.
  • Reviews history & performs physical examinations, by evaluating the patient’s medical condition and health history, ordering and interpreting results from laboratory and diagnostic tests or procedures, diagnosing health conditions and documents the findings in the patient’s medical record.
  • Manages chronic and complex conditions through collaboration with the patient and their care team by developing an individualized plan of care, prescribing medications and / or treatments.
  • Conducts complex conversations with patients and caregivers to determine goals of care in development of care plan.  Educates patients and caregivers in understanding advanced directives based on patient’s goals.
  • Educates patient and caregivers regarding medications, side effects, treatment, illness progression, diet and nutrition, medical adherence and crisis anticipation and prevention.
  • Implements interventions to support the patient with chronic conditions to decrease the recurring hospitalizations. Monitors the effectiveness of interventions.
  • Facilitates patient transitions between health care settings as well as transitions from home care to palliative and palliative to hospice.
  • Work with the Director of Hospice & Palliative Care to be a resource and provide education on palliative and hospice care within the community as well as the agency staff regularly.
  • Establishes, builds and nurtures relationships hospital and skilled nursing facility referral sources to facilitate program growth.
  • Communicates with other community health practitioners to coordinate the plan of care.
  • Communicates and collaborates with the interdisciplinary group to create, review and revise the patient’s plan of care.
  • Maintains knowledge of and compliance with current Medicare/Medicaid, state/federal rules and regulations for professional (palliative care, advanced disease management, transitional and chronic care) services.
  • Ensures compliance with the Medicare conditions of participation and other state regulations govern the provision of healthcare.
  • Complies with all Health Insurance Portability and Accountability Act (HIPAA) requirements in accordance with federal, state and organizational policies.




  • Graduate of a nationally accredited school of nursing.
  • Baccalaureate degree in nursing with a minimum of four years acute care experience, and one year as a nurse practitioner.
  • Completion of a certificate granting program, preferably master’s level as a Nurse Practitioner in Adult or Family Health.
  • Current licensure as a registered nurse practitioner in Rhode Island and Massachusetts. (If MA Nursing License is not held at time of hire, employee will be given 1 year from hire date to obtain).
  • Granted pharmacy privileges as administered through Rhode Island and Massachusetts State law and the Rhode Island and Massachusetts Nurse Practice Act.




  • Full Time, Salary, Exempt
  • Portsmouth, RI (Home Office)
  • Benefit eligible, PTO to start






Visiting Nurse Home & Hospice is an Equal Opportunity Employer. It is the policy of Visiting

Nurse Home & Hospice to provide equal employment opportunities without regard to race,

color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental

status, marital status, national origin, age, disability, genetic information (including family

medical history), political affiliation, military service, veteran status, any other non-merit

based factors, or any other protected characteristic under applicable law.


Applications must be submitted in writing to Dawn Pagliaro in Human Resources

Via email to dpagliaro@visitingnursehh.org or via fax to 401-682-7562.