Clinical Director / Director of Patient Care Services (DPCS)
Reports To
CEO / Administrator
Position Summary
The Clinical Director / Director of Patient Care Services (DPCS) is responsible for the overall clinical compliance, regulatory oversight, quality management, and operational leadership of the agency’s home health services. This position ensures full compliance with Medicare Conditions of Participation (CoPs), California state regulations, and ACHC standards.
The Clinical Director serves as the designated Clinical Manager under Medicare CoPs and maintains final clinical oversight authority over patient care delivery, documentation integrity, OASIS accuracy, QAPI activities, survey readiness, ADR management, and staff clinical performance.
This is a leadership position requiring consistent availability to ensure patient continuity of care, regulatory compliance, staff support, and immediate response to emergent clinical situations.
Authority & Accountability
- Final clinical oversight of all patient care services
- Clinical decision-making and plan of care compliance
- Admissions approval or denial based on clinical appropriateness
- Implementation of corrective action plans
- Enforcement of documentation standards and productivity expectations
- Oversight of OASIS accuracy and submission integrity
- Investigation of clinical incidents and quality concerns
- Clinical staffing oversight and patient assignment decisions
- QAPI implementation and performance improvement initiatives
- Ownership of all Additional Documentation Requests (ADRs)
- Regulatory readiness and survey preparation activities
- Maintains full ownership and accountability for all ADRs
- Clinical Compliance & Oversight
- Oversees all direct and indirect clinical services provided by the agency.
- Ensures compliance with Medicare Conditions of Participation and California regulations.
- Functions as Clinical Manager as defined under Medicare CoPs.
- Ensures individualized Plans of Care are developed, implemented, and updated appropriately.
- Oversees clinical documentation timeliness, accuracy, and regulatory compliance.
- Conducts clinical record reviews and audits.
- Ensures appropriate clinical staffing and patient assignment oversight.
- Serves as the primary clinical escalation resource for field staff, physicians, hospitals, referral sources, and community partners.
OASIS & Documentation Integrity
- Oversees OASIS assessment accuracy, validation, correction processes, and submission integrity.
- Reviews OASIS scoring trends and outcomes data.
- Monitors OASIS outcomes and develops corrective action plans as needed.
- Ensures documentation supports medical necessity and reimbursement compliance (PDGM).
- Monitors timely chart completion and EMR compliance.
- Addresses clinician documentation deficiencies and ensures corrective action when indicated.
ADR & Audit Management
- Oversees all ADR activity, including document collection, chart review, submission tracking, and timely response to payer requests.
- Maintains an ADR tracking system and ensures all requests are completed and submitted within required deadlines.
- Collaborates with clinicians, medical records, physicians, referral sources, and leadership to obtain required documentation and resolve ADR deficiencies.
- Monitors ADR outcomes and trends and implements corrective action plans when deficiencies are identified.
- Escalates barriers that may impact compliance or submission deadlines.
Physician Orders & Documentation Management
- Oversees timely processing, tracking, and physician signature compliance for all orders, plans of care, and supplemental physician documentation.
- Monitors outstanding unsigned orders and implements corrective action plans to maintain regulatory compliance.
QAPI & Performance Improvement
- Leads and oversees the agency’s QAPI program.
- Reviews hospitalizations, infections, falls, incidents, complaints, grievances, missed visits, and patient satisfaction data.
- Reviews agency KPIs including patient satisfaction, rehospitalization rates, documentation timeliness, productivity, incident trends, and quality outcomes.
- Develops and implements corrective action plans.
- Prepares quality reports and ensures survey readiness at all times.
- Reports quality outcomes and performance improvement initiatives to leadership.
Labor Distribution & Productivity Oversight
- Monitors clinician productivity and visit utilization.
- Reviews overtime trends and staffing efficiency.
- Adjusts staffing oversight based on census fluctuations.
- Partners with leadership on clinical budget management.
- Participates in workforce planning to support census growth and patient care needs.
On-Call & Availability Requirements
- Serves in the agency’s on-call rotation as assigned.
- Must remain accessible to clinical staff, physicians, referral sources, patients, and leadership.
- Responds promptly to emergent clinical situations, urgent patient concerns, hospitalizations, after-hours escalations, and staff questions.
- Provides clinical decision-making and administrative oversight during on-call coverage.
- Ensures continuity of clinical leadership coverage during absences and scheduled time off.
- Inconsistent accessibility may be subject to performance review.
Risk Management & Patient Safety
- Oversees investigation, documentation, and follow-up of adverse events and incidents.
- Monitors infection control compliance.
- Reviews rehospitalization trends.
- Oversees investigation and resolution of patient, family, referral source, and employee complaints and grievances.
- Ensures corrective actions are documented, implemented, and tracked for effectiveness.
Regulatory Readiness
- Maintains agency survey readiness at all times.
- Ensures compliance with ACHC standards.
- Oversees clinical record retention requirements.
- Conducts routine compliance reviews and mock survey activities.
- Communicates regulatory updates to staff and ensures implementation of required changes.
Staff Supervision & Development
- Hires, supervises, evaluates, disciplines, and terminates clinical personnel.
- Conducts annual and as-needed performance evaluations.
- Completes employee evaluations within required timeframes.
- Oversees orientation and competency validation.
- Ensures annual competencies, skills validations, and required clinical education are completed and documented.
- Implements in-service and regulatory training updates.
- Provides coaching, mentoring, competency validation, and corrective action as needed.
Leadership Accountability
- Maintains ownership of assigned projects, initiatives, deadlines, and regulatory deliverables.
- Proactively communicates barriers, delays, and operational concerns with recommended solutions.
- Ensures assigned responsibilities are completed within established deadlines or escalated appropriately when assistance is needed.
- Maintains confidentiality of patient, employee, leadership, financial, and operational information.
- Demonstrates professionalism, accountability, sound judgment, and ethical leadership conduct.
Position Qualifications
- Current Registered Nurse (RN) license in California (required) or licensed physician in California.
- BSN required; Master’s degree preferred.
- Minimum three (3) years management experience in home health.
- Strong knowledge of Medicare CoPs, ACHC standards, OASIS, PDGM, ADRs, and California regulations.
- Demonstrated experience leading QAPI and compliance programs.
- Strong leadership, regulatory interpretation, decision-making, communication, and organizational skills.
Disclosure
Duties and responsibilities may be adjusted at the discretion of the Company to meet regulatory requirements, operational demands, and the best interests of the organization.
Job Type: Full-time
Pay: $120,000.00 - $140,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Relocation assistance
- Vision insurance
Medical Specialty:
- Geriatrics
- Home Health
- Medical-Surgical
- Wound Care
Ability to Relocate:
- Fresno, CA 93793: Relocate before starting work (Required)
Work Location: In person
