Schedule: Weekends + after-hours on-call

Compensation: Starting compensation range $35.00 - $45.00 hourly Exact compensation will be based on job-related factors including experience, education, licensure, certifications, and location, in accordance with applicable laws.

On-call: This position participates in the organization's on-call program. Employees scheduled for on-call coverage are eligible for on-call compensation and any applicable compensation for time worked while responding to patient care needs, in accordance with company policy and applicable law.

Benefits:

• Comprehensive medical, dental, and vision insurance package (full-time)
• 401(k) retirement plan
• Assistance with licensure renewal
• Generous PTO policy
• The opportunity to build from the ground up and put your stamp on a growth-stage organization!

Position Overview

The Licensed Vocational Nurse (LVN) is an essential member of the interdisciplinary care team, delivering skilled, compassionate nursing care to patients and families navigating life-limiting illness. Working under the supervision of a Registered Nurse (RN) and in close collaboration with the full interdisciplinary team (IDT), the LVN provides direct patient care across care settings — including private homes, skilled nursing facilities (SNFs), assisted living facilities (ALFs), and residential care settings.

This role sits at the intersection of clinical excellence, patient and family experience, and mission-driven care. The LVN is accountable for skilled nursing visits, timely and accurate documentation, effective symptom management, and meaningful family support — all while serving as a trusted representative of the organization’s values at every bedside.

This role requires strong clinical judgment, emotional intelligence, and the ability to work independently in a field-based environment. LVNs are expected to operate with accountability, urgency, and a deep sense of ownership over the quality and consistency of care they deliver.

Key Responsibilities

Clinical Care & Patient Support

• Perform skilled nursing visits per the patient’s Plan of Care (POC), including wound care, catheter care, medication administration, and pain and symptom monitoring
• Conduct thorough patient assessments at each visit and report changes in condition to the supervising RN or attending physician in a timely manner
• Administer medications, treatments, and nursing interventions as ordered and within LVN scope of practice per California BRN guidelines
• Monitor and document vital signs, pain levels, comfort measures, and overall patient status with accuracy and consistency
• Ensure patients have access to comfort kit medications and that families are educated on their proper use
• Provide personal care instruction and hands-on education to family members and caregivers, reducing burden and promoting confidence in the home

Patient & Family Education / Experience

• Serve as a compassionate, clear, and culturally sensitive communicator during emotionally complex conversations at the bedside
• Educate patients and families on hospice philosophy, disease progression, comfort care goals, and what to expect through the end of life
• Address patient and family concerns and barriers to care with empathy and professionalism, escalating to the RN or social worker as appropriate
• Recognize signs of caregiver or family distress and ensure connection to the appropriate IDT support services
• Provide immediate emotional presence and bereavement support to families at the time of passing

Interdisciplinary Team (IDT) Collaboration

• Participate actively in IDG/IDT meetings, contributing timely and relevant clinical observations on assigned patients
• Collaborate with RNs, social workers, chaplains, aides, and physicians to ensure holistic, coordinated care aligned with patient goals
• Communicate proactively with the supervising RN regarding changes in patient condition, urgent family concerns, or care plan adjustments
• Support care transitions between levels of care — RHC, CHC, GIP, and Respite — as directed by the clinical team

Documentation, Compliance & Quality

• Complete accurate and timely clinical documentation in the EMR per agency policy and CMS hospice Conditions of Participation (CoPs)
• Ensure all visit notes, medication administration records, and care coordination entries are completed on the day of service
• Adhere to Medicare and Medi-Cal hospice benefit guidelines, maintaining full compliance with applicable state and federal regulations
• Maintain patient confidentiality in accordance with HIPAA at all times
• Participate in audits, chart reviews, and quality improvement initiatives as requested

On-Call & Urgent Response

• Participate in rotating on-call schedule, responding to urgent patient and family needs during evenings, weekends, and holidays
• Conduct urgent and after-hours visits as needed to manage acute symptoms, provide family support, or carry out pronouncement per agency protocol
• Document all urgent visits and communicate clinical changes to the supervising RN promptly and thoroughly

Perform other job-related duties as assigned.

Performance Outcomes & Key Metrics

Clinical Quality & Compliance (40%)

• Accurate and consistent skilled nursing visits completed per patient Plan of Care
• Timely documentation with zero material deficiencies; chart audit compliance = 99%
• Appropriate and proactive escalation of patient changes to the supervising RN

Patient, Family & Partner Experience (30%)

• High patient and family satisfaction reflected in feedback and survey scores
• Positive feedback from IDT members, facility staff, and referral partners
• Demonstrated professionalism, empathy, and responsiveness at every interaction

Operational Accountability (20%)

• Consistent on-time visit completion and same-day documentation
• Reliable participation in on-call rotation with appropriate coverage and follow-through
• Effective coordination and handoff with the IDT following complex visits or patient changes

Culture & Team Contribution (10%)

• Consistent demonstration of accountability, urgency, and emotional intelligence
• Active collaboration with RNs, aides, social workers, and operations staff
• Participation in training, skills development, and continuous improvement initiatives

• Active, unrestricted Licensed Vocational Nurse (LVN) license in the State of California
• Minimum 1 year of clinical nursing experience; hospice, home health, SNF, or palliative care experience strongly preferred
• Working knowledge of hospice eligibility criteria and Medicare hospice regulations
• Exceptional communication, interpersonal, and clinical judgment skills
• Ability to manage complex conversations with patients and families during emotionally sensitive situations
• Proficiency with EMRs and clinical documentation systems; Devero preferred
• Current CPR/BLS certification
• Valid California driver’s license, reliable personal vehicle, and proof of current auto insurance
• Must be available to respond to patient, family, and staff needs during assigned on-call shifts, including evenings, weekends, and holidays.

Preferred Qualifications

• Prior hospice or palliative care field experience with familiarity of the Medicare Conditions of Participation (CoPs)
• CHPLN (Certified Hospice and Palliative Licensed Nurse) certification, or willingness to obtain
• Experience working in hospital-based, SNF, or joint venture hospice models
• Bilingual skills (English/Spanish strongly valued for serving our diverse patient population)
• Experience with IV therapy, wound care, Foley catheter management, and complex symptom management

Work Environment & Physical Requirements

• Ability to perform job duties across a variety of settings, including patient homes, assisted living communities, skilled nursing facilities, and inpatient environments.
• Ability to respond promptly to calls, messages, and urgent operational or patient care needs.
• Must remain accessible by phone and, when applicable, be able to report to designated locations within required response times.
• Regular standing, walking, and driving between patient visits or work locations.
• Frequent bending, stooping, kneeling, and reaching while providing care or completing assessments.
• Ability to lift or assist with moving patients and equipment up to 50 pounds, with or without reasonable accommodation; additional support or equipment may be used for heavier transfers.
• Sufficient hand dexterity to complete clinical tasks such as administering medications, documenting in electronic systems, and using medical equipment.
• Visual and hearing ability to safely assess patients and communicate clearly with patients, families, and team members.
• Ability to respond appropriately in urgent or emergency situations, including performing CPR if required.
• Comfort working in a range of home environments, including exposure to pets, smoke, and varying indoor/outdoor conditions.
• Regular use of computers, tablets, and mobile devices for documentation, communication, and virtual meetings; ability to sit for extended periods while completing electronic charting and administrative tasks.
• Reliable transportation and ability to travel within the service area.
• Ability to manage the physical and emotional aspects of working in end-of-life care.

Cultural Expectations

LVNs are expected to:

• Take full ownership of outcomes, not just tasks — every visit matters
• Operate with urgency while maintaining compassion and professionalism at the bedside
• Communicate clearly, directly, and respectfully with patients, families, and all team members
• Uphold the highest standards of integrity, accountability, and emotional intelligence
• Serve as a trusted representative of Loma Linda University Hospice’s mission and values at all times

About Palomar Health Palliative & Hospice

Palomar Health Palliative & Hospice is dedicated to a patient-first mission, ensuring compassionate, high-quality care that supports patients and families through every stage of need. Our culture is defined by data-driven excellence, operational transparency, and a steadfast commitment to its core values of Dignity, Integrity, Compassion, Excellence and Partnership. With an expanding network through partnerships, Palomar Health Palliative & Hospice is positioned for continued growth and innovation as it scales to new markets.

Palomar Health Palliative & Hospice is an equal opportunity employer and is committed to a policy of equal employment opportunity for all employees and applicants. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected status in accordance with applicable federal, state, and local laws. All employment decisions are based on job requirements, individual merit, and business needs.