Medical Director Designee
Description
Medical Director
Job Description
Reports To:
Administrator
Appointed By:
Governing Body (in writing)
Employment Type:
Employed or contracted; full-time or part-time
Regulatory Ref:
22 CCR §§ 74800(a)(37), 74856, 74860, 74868, 74880 | 42 CFR Part 418 | ACHC Hospice Standards
Effective Date:
June 22, 2026
POSITION SUMMARY
The Medical Director is a licensed physician and surgeon appointed in writing by the Governing Body who is responsible for the overall medical direction of the hospice program. The Medical Director provides oversight of physician services by complementing attending physician care, acting as a medical resource to the interdisciplinary team, assuring continuity of hospice medical services, and assuring appropriate measures to control patient symptoms. The Medical Director ensures that all medical components of care meet applicable federal and California state requirements and ACHC accreditation standards.
The Medical Director serves as a hospice champion in the community, promoting and representing the program to physicians, physician groups, discharge planners, referral sources, community health organizations, and potential donors, as appropriate. The Medical Director may be employed or contracted with the hospice on a full-time or part-time basis.
ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES
• Devoting best ability to the proper management and medical direction of the hospice program.
• Providing overall medical direction to the program; assuring that established policies, bylaws, rules, and regulations of the organization are followed.
• Adhering to requirements, terms, and conditions required by the Medicare Conditions of Participation (42 CFR Part 418), ACHC standards, and all applicable federal and California state statutes governing the provision of hospice services.
• Establishing and continually reviewing policies and procedures related to patient care, medical education, and emergency procedures.
• Developing and reviewing, in cooperation with the Administrator and/or DPCS, criteria to monitor the quality of education programs provided to physicians, personnel, and volunteers.
• Evaluating QAPI plans and monitoring to identify medical education needs; participating in QAPI teams and activities as needed.
• Proposing organizational programs to address identified needs, with input from appropriate specialists.
• Working with the Administrator and/or DPCS to determine the impact of implemented programs on quality of care.
• Serving as a hospice champion in the community; acting as a liaison to community physicians by providing consultation and education regarding hospice and palliative care admission criteria.
• Providing training on medical aspects of caring for terminally ill patients to physicians, personnel, and volunteers.
• Consulting with attending physicians regarding pain and symptom management for hospice patients; managing oversight of patients' medications and treatments.
• Acting as medical resource to the hospice interdisciplinary team; attending IDT meetings and working collaboratively with the team.
• In conjunction with the attending physician and IDT, reviewing and updating the plan of care at least every 15 days, or more frequently as needed, per 22 CCR § 74872.
• Documenting care provided in the patient's clinical record, providing evidence of progression of the end-stage disease process.
• Acting as primary physician for patients whose attending physicians desire to relinquish that care or are not available.
• Maintaining current knowledge of the latest research and trends in hospice care and pain/symptom management.
• Reviewing and developing protocols for treatment; proposing current options for interventions.
• Developing and implementing procedures and protocols regarding OSHA standards, including the handling of hazardous medications.
• Demonstrating knowledge in communications and counseling patients and family/caregivers dealing with end-of-life issues.
• Participating in resolution of interpersonal conflict and issues of clinical and ethical concern.
• Ensuring competent physician services are routinely available on a 24-hour basis to meet general medical needs of hospice patients to the extent not met by the attending physician.
• Assisting with evaluation of protocols and procedures with respect to quality and cost outcomes.
Regulatory-Specific Responsibilities (22 CCR §§ 74856, 74860, 74864, 74868, 74872):
• Certifying and recertifying terminal illness for all patients admitted to hospice, in consultation with the attending physician, prior to providing care and for all subsequent benefit periods (§ 74860(c)).
• Ensuring each initial certification of terminal illness includes: an individualized clinical narrative supporting life expectancy of 12 months or less; an attestation statement immediately above the Medical Director's signature; and all clinical information supporting the medical prognosis (§ 74860(c)(3)).
• Consulting on comprehensive assessments and serving as the certifying/consulting physician when a patient does not have an attending physician or the attending is unavailable (§ 74864(b)).
• Approving and signing plans of care when the attending physician is unavailable (§ 74868(f)).
• Approving, in writing, all modifications proposed to a patient's plan of care (§ 74868(g)).
• Performing face-to-face encounter assessments within 30 days of the third and subsequent hospice benefit certification periods, and attesting to the encounter. (A nurse practitioner may complete the encounter and report findings to the Medical Director.)
• Notifying CDPH within 10 business days of any change in Medical Director or Medical Director Designee, by submitting the required change of Medical Director application per § 74828(b).
• Ensuring any vacancy in the Medical Director or Medical Director Designee positions is filled within 60 days of occurrence.
The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this position. The Medical Director may be requested to perform job-related tasks other than those stated in this description.
Medical Director Designee
Job Description Addendum
Appointed By:
Administrator
Regulatory Ref:
22 CCR §§ 74800(a)(38), 74856(c)-(g)
Primary JD:
See Medical Director Job Description
Effective Date:
June 22, 2026
PURPOSE OF THIS ADDENDUM
This addendum supplements the Medical Director Job Description. All qualifications, training requirements, and essential job functions set forth in the Medical Director Job Description apply equally to the Medical Director Designee. This document addresses the specific appointment authority, scope, and regulatory obligations unique to the Designee role.
ROLE AND SCOPE
• The Medical Director Designee assumes all responsibilities and obligations of the Medical Director when the Medical Director is not available.
• When not acting in the Designee capacity, the individual may hold other roles within the hospice consistent with their licensure and qualifications.
• The Medical Director Designee must maintain sufficient familiarity with all hospice operations, policies, and regulatory requirements to fulfill the Medical Director role without interruption to care or compliance.