Summary

VA Black Hills Health Care System (VA BHHCS) is seeking a Physician Assistant (PA) to care for Veterans at the BHHCS Community Living Center (CLC) with the expectation to expand services to our Veterans with neurocognitive disorders having a focus on caring for Veterans with dementia in the CLC and as a provider of a home-based memory care (HBMC) team. This vacancy is posted as a Physician Assistant and Advanced Practice Nurse for one position.

Duties

• The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers
• This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest
• As an employee operating in a Whole Health System of care - you will operate in a model with three core elements - seeking to create a personalized health plan for each Veteran
• This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community
• This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being
• Specific practice setting is at Hot Springs CLC with plans to expand the Home-Based Primary Care (HBPC) Program and start a Home-Based Memory Care (HBMC) Team specializing in care of Veterans with dementia
• The PA will collaborate with physician and interdisciplinary health team members to identify - implement - test - and export novel approaches to optimizing quality of life of older Veterans and Veterans with neurocognitive disorders/dementia
• Scope of Assigned Duties include - but are not limited to: Obtains medical histories and performs physical examinations - at admission to CLC and annually
• Documents Discharge Note and Discharge Summaries at the time of discharge
• Provides and coordinates medical care for assigned patients - including establishing diagnoses - formulating - and implementing care plans - and providing follow-up care
• Orders and interprets diagnostic testing results and therapeutic modalities - including but not limited to laboratory tests - ECG - radiological studies - hemodynamic monitoring - treatments - limited IV fluids/electrolytes - oxygen - etc. - based on the current CLC treatment guidelines of stable patients
• Orders ancillary services - including but not limited to - pharmacy - social services - physical medicine and rehabilitation therapies - prosthetic services - etc
• and attend CLC Interdisciplinary Team to coordinate care for CLC Veterans
• Orders VA specialty service consults and initiating requests for non-VA medical care and consults in accordance with VHA and local facility policy and procedures
• Orders interfacility transfers and other transportation for CLC Veterans
• Orders or prescribes devices - supplies - and durable medical equipment
• Orders or prescribes medications for patients under their care consistent with privileges
• Obtains and documents informed consent for treatments and procedures for which the PA is responsible according to the BHHCS Medical Bylaws
• Provides education and counsels patients and families in preventive care - medical conditions - and the use of prescribed treatments and drugs
• Conducts Goals of Care Conversations with high-risk patients regarding any desired limitation in life-sustaining treatments and choice of surrogate as well as enter the Life-Sustaining Treatment Decisions (LST) progress note and corresponding orders when Veteran is under their care or if delegated by the attending physician
• Telehealth Modalities may be utilized for the provision of care by an authorized provider pursuant to Service level guidance - required training and instruction - and in collaboration with the Facility Telehealth Coordinator (FTC)
• Provides clinical oversight and participates in peer review of other Rehabilitation and Extended Care (REC) providers through periodic chart reviews
• Acts as a surrogate for absent CLC providers as needed - to include review of EMR view alerts and other duties as assigned
• Regularly attends all provider meetings - departmental meetings and medical staff meetings as requested
• Conducts home visits to assess needs of patients and their caregivers enrolled in home-based primary care and the home-based memory care team
• Performs comprehensive medical assessments/ evaluations in the patients' home setting with consultation with Medical Director - as needed
• Performs medication reconciliation in home setting
• Manages and treats medical conditions in the home setting - involving Medical Director as needed
• Formulates multi-disciplinary treatment plans
• Provides health education to patients and their caregivers
• Responds to telephone calls from patients and caregivers regarding their health care
• Coordinates with community nursing home program liaison and CLC admissions team - and at times the state Veterans' home and community nursing homes for continuity of care of veterans with neurocognitive disorders as the disease progresses and they need skilled nursing home care
• Refers patients to appropriate community or VA programs
• Work Schedule: Monday - Friday - 7:30am - 4:00pm Telework: Available (Ad-hoc) Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized