VIKING HOSPICE CARE
Strength in Caring
Houston, TX \| Medicare Certified \| Locally Owned and Operated
DIRECTOR OF NURSING
Hybrid Clinical Leadership Role \| Greater Houston, TX \| Hourly Compensation
ABOUT VIKING HOSPICE CARE
Viking Hospice Care is a Medicare\-certified, independently owned hospice agency providing end\-of\-life care throughout greater Houston, including Harris, Fort Bend, Montgomery, and Brazoria Counties. The agency is committed to individualized, relationship\-centered care delivered by a clinical team that upholds the highest standards of quality, compliance, and compassion.
As a locally owned independent agency, Viking Hospice Care offers patients, families, and referral partners responsiveness and personal accountability that distinguish independent providers from large corporate hospice organizations. The agency is in an active growth phase and is building a clinical leadership team commensurate with that commitment.
POSITION SUMMARY
The Director of Nursing (DON) serves as the clinical authority for Viking Hospice Care, with full accountability for the quality, compliance, and oversight of all patient care services. This position ensures that care delivery meets or exceeds the standards established by the Centers for Medicare and Medicaid Services (CMS) Conditions of Participation, the Hospice Quality Reporting Program (HQRP), and applicable Texas state regulations.
This is a hybrid clinical leadership role structured to support the agency during its initial growth phase. In addition to full Director of Nursing responsibilities, the incumbent carries a direct patient caseload and participates in the after\-hours on\-call rotation during Phase 1 of operations. As patient census grows and additional clinical staff are engaged, direct patient care responsibilities will transfer to RN Case Managers and the Director of Nursing will transition to a full\-time clinical leadership and oversight function.
This position is well suited to an experienced hospice clinician seeking a leadership opportunity with the scope, autonomy, and long\-term trajectory of a senior clinical role in a growing independent agency.
ROLE STRUCTURE
ROLE OVERVIEW
Employment Type
Hourly; part\-time during Phase 1, transitioning to full\-time as census grows
Phase 1 Hours
Approximately 10 to 30 hours per week, inclusive of DON administrative duties and direct patient visits
On\-Call Structure
Alternating weekly rotation shared with per diem RN; one week on call, one week off
Phase 2 Transition
As census grows, direct patient care responsibilities transfer to RN Case Managers; the Director of Nursing assumes a full\-time clinical leadership and oversight function
Service Area
Harris, Fort Bend, Montgomery, and Brazoria Counties
Work Location
Field\-based for patient visits; hybrid for administrative duties (office and remote)
KEY RESPONSIBILITIES
Clinical Oversight and Quality Management
● Provide clinical leadership and oversight for all patient care services in accordance with individualized Plans of Care and CMS Conditions of Participation
● Review, approve, and maintain Plans of Care for all active patients in collaboration with the attending physician and interdisciplinary team
● Facilitate Interdisciplinary Team (IDT) meetings at intervals no less than every 15 calendar days per patient, ensuring full disciplinary participation and compliant documentation
● Conduct clinical supervisory visits and medical record audits to assess care quality, identify documentation deficiencies, and implement corrective action
● Oversee the Hospice Outcomes and Patient Evaluation (HOPE) assessment process, ensuring accurate and timely submission in compliance with HQRP requirements
● Maintain continuous survey readiness, including staff training records, policy adherence, and documentation integrity
● Review all clinical visit notes for quality and completeness; identify and remediate deficiencies in a timely manner
● Conduct registered nurse supervisory visits with Hospice Aides at intervals required by the Plan of Care and no less than every 14 days
● Administer the agency Quality Assessment and Performance Improvement (QAPI) program, documenting metrics and tracking improvement interventions on a monthly basis
● Ensure all verbal physician orders are converted to written signed orders within 24 hours
Staff Supervision and Regulatory Compliance
● Recruit, onboard, supervise, and evaluate all clinical personnel including RN Case Managers, Hospice Aides, Medical Social Workers, and Chaplains
● Maintain personnel files for all clinical staff, including current licensure, CPR certifications, TB screening documentation, background check records, and annual competency evaluations
● Conduct or coordinate competency evaluations for all clinical staff at hire and on an annual basis
● Ensure controlled substance management, DEA documentation, and medication disposal protocols are consistently implemented and documented
● Coordinate with the Medical Director on terminal prognosis documentation, recertification Certifications of Terminal Illness, face\-to\-face encounter requirements, and physician order management
PHASE 1 CLINICAL RESPONSIBILITIES
The following responsibilities are specific to Phase 1 of operations. As patient census increases and additional RN Case Managers are engaged, direct patient care responsibilities will be transferred and the Director of Nursing will assume a full\-time oversight function.
Direct Patient Care
● Conduct scheduled and unscheduled clinical visits to patients in private residences, assisted living facilities, and skilled nursing facilities throughout the greater Houston service area
● Perform comprehensive clinical assessments at each visit, including evaluation of pain, symptom burden, medication efficacy, and patient and family needs
● Complete and submit all visit documentation in Hospice Tools on the day of service
● Conduct admission visits, including comprehensive clinical assessment, execution of Election of Hospice Benefit documentation, completion of consent processes, and initiation of the Plan of Care
● Perform death pronouncements; manage and document controlled substance collection and disposal in accordance with DEA requirements; provide appropriate support to the patient family
After\-Hours On\-Call Coverage
● Serve as the primary after\-hours clinical contact during designated on\-call weeks, rotating weekly with the per diem RN
● Triage after\-hours calls, provide clinical guidance to patients and families, and assess the need for home visits
● Respond to clinical escalations requiring physician consultation, order management, or direct patient intervention
● Document all after\-hours communications in Hospice Tools prior to the start of the following business day
● Accept and process verbal orders from attending physicians; ensure corresponding written orders are obtained within 24 hours
COMPENSATION
The Director of Nursing position is compensated on an hourly basis. All time worked, including DON administrative duties, direct patient care visits, on\-call hours, and after\-hours call response, is compensated at the same hourly rate. The compensation range reflects the seniority, clinical scope, regulatory accountability, and dual\-function nature of the role.
COMPENSATION SUMMARY
Hourly Rate
$45 to $55 per hour, commensurate with experience and qualifications
Phase 1 Hours
Approximately 10 to 30 hours per week; variable based on patient census and visit volume
Phase 2 Hours
Full\-time hours upon transition to clinical leadership and oversight function
On\-Call Compensation
All hours worked during on\-call periods are compensated at the standard hourly rate, including calls handled by phone and home visits made
Mileage Reimbursement
Reimbursed at the current IRS standard mileage rate for all patient visit travel
QUALIFICATIONS
Required Qualifications
● Current, unrestricted Registered Nurse (RN) license issued by the Texas Board of Nursing, in good standing
● Minimum of three (3\) years of clinical experience in a Medicare\-certified hospice setting, including at least one (1\) year in a supervisory, clinical management, or leadership capacity
● Demonstrated knowledge of CMS hospice Conditions of Participation, HQRP reporting requirements, and hospice clinical documentation standards
● Experience facilitating Interdisciplinary Team meetings and maintaining associated clinical documentation in compliance with CMS requirements
● Demonstrated ability to operate independently in both field\-based and remote administrative capacities with limited supervision
● Experience with after\-hours on\-call coverage and independent clinical decision\-making in a home\-based hospice setting
● Experience performing death pronouncements and managing controlled substance disposal in accordance with DEA requirements
● Reliable personal vehicle and willingness to travel throughout Harris, Fort Bend, Montgomery, and Brazoria Counties
● Smartphone with capability to operate the Hospice Tools mobile application on iOS or Android
Preferred Qualifications
● Prior service as Director of Nursing, Assistant Director of Nursing, or Clinical Manager at a Medicare\-certified hospice agency
● Experience contributing to the startup, licensure, or initial CMS certification of a new hospice provider
● Proficiency with Hospice Tools or comparable hospice EMR platforms, including Axxess, Netsmart, or MatrixCare
● Certified Hospice and Palliative Nurse (CHPN) designation issued by the Hospice and Palliative Credentialing Center
● Familiarity with the HOPE assessment instrument and HQRP quality measure reporting requirements
● Bilingual proficiency in English and Spanish
Viking Hospice Care is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by applicable law.
Pay: $45\.00 \- $55\.00 per hour
Benefits:
- Health insurance
- Paid time off
Work Location: In person