Executive Director

July 14, 2017

Summary of Duties and ResponsibilitiesThe Executive Director (ED) also titled Hospice Administrator is responsible for overall direction and operation of all Hospice services, functions and activities in accordance with goals and policies approved by the Board of Directors, and in compliance with local, State and Federal laws and regulations.

Reporting Relationship:  To the Board of Directors

Position Type:   Exempt, Full Time, Benefited, Contractual- Wage Range Start $ 120,598. to End $ 166,940.

Job Details and Essential Functions:

  • Assumes full legal authority and responsibility for the management of the hospice, the provision of all hospice services, its fiscal operations, continuous quality assessment and performance improvement, and compliance to all Federal and State regulations.(42 CFR 418.100(b)
  • Participates in the development and preparation of and adherence to the operational and capital budget, the implementation and oversight of the accounting system, and the management of Hospice resources to ensure their safe and effective utilization.
  • Establish, implement and evaluate goals and objectives for hospice services that meet and promote high standards of quality and ethical compliance.
  • Promotes effective planning and utilization of agency resources for efficient and cost effective delivery of quality patient care.
  • Oversees the development of HOF policies and procedures for personnel in accordance with State and Federal regulations.
  • Oversees the development of HOF policies and procedures for the delivery of patient care services in Hospice in accordance with standards as established by regulatory or accrediting bodies.
  • Collaborates in strategic planning with other members of Senior Leadership, obtaining input from the Hospice Senior Leadership Team.
  • Performs at speaking engagements in representation and on behalf of Hospice, provides in-service education as required and promotes HOF through community involvement and participation in professional organizations.
  • Directly oversees the Quality Assessment/Performance Improvement Program (QAPI).
  • Prepares Annual Agency Evaluation.
  • Complies with all licensing and regulatory agency requirements relating to Hospice services.
  • Performs other duties as requested by the Board of Directors.

Required Knowledge and Skills

  • Demonstrates commitment to own professional development.
  • Excellent listening, verbal, and written communication skills.
  • Demonstrates a willingness to work constructively and cooperatively with other members of the hospice team and reflect concern for the well-being of patients and employees.
  • Ability to lead staff effectively and coach to improve function and delivery of agency services
  • Demonstrates a commitment to providing high quality hospice services as evidenced by appropriate professional behavior.
  • Public speaking, developing relationships with identified partners, groups, businesses with whom Hospice of the Foothills may have or need to establish affiliation.

Education & Experience


  • Bachelors Degree in health, nursing, hospital or business administration, or other applicable field
  • Five years of supervisory or administrative experience in a hospice, community health service, or home health service.


  • A Master’s Degree in public health, nursing, hospital or business administration or other applicable field
  • Hospice Certification

 License / Certifications


  • Possess and maintain valid California driver’s license, a reliable automobile and evidence of appropriate liability insurance


Visit Nurse, LVN

July 7, 2017

Summary of Duties and ResponsibilitiesProvides direct care to patients under the supervision of a Registered Nurse (RN) in accordance with Medical Director Orders and plan of care.

Primary Department: Outpatient Unit  

Reporting Relationship:  Clinical Care Manager

Position Type:   Non-Exempt / Wage Range Start $ 25.44 to End $ 33.19

Job Details and Essential Functions:

  • Under the direction and supervision of a Registered Nurse (RN), provides direct patient care including specialized duties related to end of life care
  • Implements current nursing practice following the plan of care
  • Provide accurate and timely documentation of patient services to reflect the plan of care in the Electronic Medical Record (EMR)
  • Collects and provides patient and family/caregiver education and information pertinent to diagnosis and self plan of care as directed by the RN
  • Participates in coordination of hospice services, appropriately reporting the identified needs to the interdisciplinary group.  Examples include hospice aide, OT, PT, SW, ST, Dietician or Clinical Supervisor.
  • Uses and prepares equipment and supplies effectively, adhering to aseptic technique
  • Provides appropriate pain/symptom management.  Monitors patient’s response to treatments/medications and reports changes to RN
  • Contributes to patient and family counseling and education
  • Participates in QAPI program and hospice sponsored in-service
  • Participates in patient care meetings and HOF in-service and training
  • Serves as back up to Hospice Aide

Knowledge and Skills
• Commitment to principles, practices and procedures of nursing in a hospice environment
• Demonstrated competence in hospice care delivery techniques, with willingness to learn ‘Most Current’ hospice nursing competencies and procedures
• Dedication to ‘Nursing Practices Act’ record keeping requirements
• Attention to details of day-to-day operations of a Congregate Living health facility
• Routine nursing skills practiced in a clinical environment
• Intolerant of conditions that are symptomatic of neglect or abuse
• Providing accurate and timely records of critical events
• Cooperation with the Governing Body, COO, CEO, physicians, IDT members, and other CLHF coworkers
• Read, write, and communicate on a professional level
• Perform multiple tasks in a timely manner


  • Public speaking, developing relationships with identified partners, groups, businesses with whom Hospice of the Foothills may have or need to establish affiliation

Education & Experience


  • Minimum one-year hospice experience or 2 years experience in a Skilled Nursing Facility.
  • Demonstrated competence in Hospice care delivery techniques
  • Knowledge of terminal care and end-of-life issues
  • Demonstrated communications and interpersonal skills, adaptability, organization, responsibility and leadership qualities


  • Two or more years experience as an LVN for an inpatient or outpatient Hospice Unit
  • Knowledge of State and Medicare Hospice regulations

License / Certifications


  • Possess and maintain current California LVN license
  • Possess and maintain current CPR certificate.
  • Possess and maintain valid California driver’s license, a reliable automobile and evidence of appropriate liability insurance



A Search Begins

June 29, 2017

In March 2014, my 36-year nursing career led me to Nevada County and Hospice of the Foothills.  I was initially a consultant and then hired as a contract employee to fill the role of interim Director of Patient Care Services.  By September, I was asked to accept the role of interim Executive Director.  Then, in January of 2015, the Board of Directors offered me a three-year contract as Hospice of the Foothills’ Executive Director.  It’s been extremely satisfying and, at times, equally stressful.  When I assumed the Executive Director position, there were many known challenges to address, key leadership positions to fill and a re-organization of departments.  It also became obvious that the Compassionate Care Home, Hospice of the Foothills’ former inpatient care facility, had been operating at a significant loss for eight years.  After researching every possible option to keep the home open, it was my duty as a steward of our community’s only non-profit hospice to recommend to the Board of Directors that we close the Home.  It wasn’t really a choice.  The business model at that time was not sustainable.  Had the Board of Directors not voted to close the Compassionate Care Home, Hospice of the Foothills would have been forced out of business.  That was perhaps the saddest and most stressful time in my professional life.  But that feeling would not last because I have had the privilege of leading a team of extremely dedicated and compassionate employees who were willing to make extraordinary sacrifices to keep Hospice of the Foothills afloat during that tumultuous year. 

We’ve come a long way since that pivotal point in 2015.  Hospice of the Foothills, as an organization, is healthier and better than ever.   Not only are we financially sustainable, but we are also compliant with all federal and state regulations. With the help of everyone in the organization, we prevailed.  I could not be prouder! 

My contract as Executive Director expires on January 31, 2018.  Now, with an eye toward the future, I will follow another path.  I am not retiring quite yet, rather looking for something less demanding with more time to spend with family and loved ones.  My husband, Richard, and I will be staying in the community we have grown to love. We are excited that my son and his family recently moved from Sacramento to Grass Valley.  Moving forward, the Board of Directors has chosen a Search Committee that will be working on recruiting a new Executive Director for Hospice of the Foothills.  In the next six months, in addition to my regular duties, I will serve as a resource for that committee.  Our goal is to have a seamless transition, so that all the progress we have made as an agency will be maintained for the benefit of the staff, the agency, and most importantly, our patients and their families.

It has been my honor serve this community.  Thank you for supporting Hospice of the Foothills through 38 years of some challenges, but mostly great successes.  The future is indeed bright!

Most respectfully yours,

Carolynn Peterson RN, MSN, AOCN, CHPCA

Executive Director

Hospice of the Foothills

Nevada County Juvenile Hall Presents a Donation

June 9, 2017
Thank you to everyone at Nevada County Juvenile Hall for donating the proceeds of the Will Bill Poker Tournement to Hospice of the Foothills. Representatives came by the office to personally present their gift! We are honored to receive this annual donation in memory of Bill Blackwell.

Don’t Let Hospice Myths Get in the Way

September 27, 2016

As healthcare and insurance coverage in this country evolves, it is more important than ever that we inform ourselves about our healthcare choices and take a proactive role in the decision-making process.  End-of-life care should be an integral part of a life-long, personalized plan of care for everyone. So why do we delay conversations with our families, friends and physicians about the kind of end-of-life care and experience we want to have?

Although there are myths and misconceptions surrounding hospice care, the mission of Hospice of the Foothills could not be more clear; to affirm life, promote dignity at the end of life, and provide comprehensive and compassionate patient care and support for families.

“If only we’d come to hospice sooner,” is the most frequent comment we hear from patients and their families. Don’t let these myths prevent you from helping your family, friends, and maybe even yourself in a time of great need.

Myth #1: Hospice is for when there is no more hope – it means ‘giving up’.

Reality: Research shows that people receiving hospice care can, depending on the life-limiting illness, live longer than similar patients who do not opt for hospice care.  Our physician participates in weekly team meetings that support patients living life to its fullest.

Myth #2: Hospice is a place.

Reality: Hospice is a philosophy of care providing nursing, emotional and spiritual care focusing on comfort and quality of life. Hospice care is most commonly delivered in patients’ homes.

Myth #3: Hospice is only for the elderly and/or people with cancer.

Reality: Hospice is for anyone with a life-limiting illness, regardless of age or diagnosis.  

Myth #4: Hospice is only for the last days.

Reality: Patients and families can receive care for six months or longer, depending on the progression of the disease.  Bereavement support is available for up to 13 months for those served by HOF.

Myth #5: Only a physician can refer a patient to hospice.

Reality: ANYONE can refer a patient to hospice ⃰.  This includes family members and friends.  Hospice staff members are available to answer questions and facilitate family discussions.

⃰(Physician certification of life-limiting prognosis required.)

 Myth #6: Patients must enroll with the hospice provider their physician recommends.

Reality: Physicians refer patients to hospice care, but patients have the right and ability to choose which hospice provider is right for them.  A patient and family can and should ‘interview’ potential providers.

 Myth #7: Hospice of the Foothills is fully funded by Medicare and other insurance.

Reality: HOF relies on the generosity of our community to provide comprehensive care and a wide range of services, and to sustain our commitment to never turn anyone away.

Talking about end-of-life care and the eventuality of death is healthy. Understanding the options available without the stress of a serious illness or injury, is key to insuring that you live well, in a way that is meaningful to you, for as long as you live.

For more information about our programs and services call 530-272-5739.

A Summer Blessing

August 30, 2016

On any given day at the Hospice of the Foothills campus, you may see 2 or 3 people slowly navigating the walkways, stopping frequently, and always looking intently at the ground. It may be puzzling to some, but the explanation is simple and quite touching. Most of the walkways and adjacent planting areas are lined with commemorative bricks engraved with personalized messages. Our ‘slow walking’ visitors are often here to find or visit their brick, and generally take time to read the tributes on some of the surrounding bricks.

From left: Joe Grande, Greg Snyder, Gil Mathew, Marilyn Streseman, Ron Keeling, Suzanne Reese, Rich Ramey, Mike Brown, Greg Gulizia, Rocco Gulizia.

From left: Joe Grande, Greg Snyder, Gil Mathew, Marilyn Streseman, Ron Keeling, Suzanne Reese, Rich Ramey, Mike Brown, Greg Gulizia, Rocco Gulizia.

The Pave the Way program started in 2008 as a Friends of Hospice fundraiser for the Hospice of the Foothills capital campaign. Over the years, the bricks have continued to be a popular commemorative program. While the majority of bricks are memorials to friends and loved ones, there are many that pay homage to special people, events, or other noteworthy occasions.

After many years of working with a Sacramento area mason who installed the bricks, Pave the Way co-chairs Suzanne Reese and Marilyn Streseman learned it was increasingly difficult for him take time away from his rapidly growing business. The time had come to find a local resource. This last June, Suzanne Reese was discussing the program needs with Joe Grande of Grande Wood Designs. When told of the challenge with the brick installation, he offered to help find a solution.

Joe Grande is a member of Twin Cities Church and belongs to a Men’s bible study group that meets every Friday morning at 6:30am. He shared the Friends of Hospice need and proposed installing the bricks as one of their community projects. Study group member, Rich Ramey, is the owner of Ramey Tile Company, so the team had the expertise to take on the job. Needless to say, the men embraced the project, seeing it as a wonderful way to express their heartfelt thanks to Hospice of the Foothills for the loving and compassionate care provided to several of their parents and loved ones.

Mike Brown and Rich Ramey set the bricks.

Mike Brown and Rich Ramey set the bricks.

Bright and early on a beautiful August morning, Joe Grande, Rich Ramey, Gil Mathew, Mike Brown, Greg Snyder, Ron Keeling, Greg Gulizia (along with his young son Rocco) arrived, making quick and joyful work of the installation. We are deeply appreciative and blessed by the kindness and generosity of this wonderful group of men. Time and again, our community members rise up and demonstrate the ‘golden spirit’ that lives in our beautiful foothills. This spirit allows Hospice of the Foothills to provide comfort and high quality end-of-life care for our patients, their families, and our community.

Hospice of the Foothills relies on the community to help support our programs and services. Please consider buying a commemorative brick or making a donation today to help bridge the growing gap between reimbursements and the actual cost of comprehensive, whole family care.


Transitions Palliative Care Program Provides Whole Patient Care

July 26, 2016

Each year, millions of people in the United States are diagnosed with a life-limiting illness. Unfortunately, too many of those patients will suffer needlessly from pain, nausea and other symptoms of their disease. Many times the treatment of the disease is the focus, and symptoms or side effects are not always addressed, or could be addressed better. The Transitions Palliative Care Program is a program that focuses on providing relief from symptoms related to disease progress or treatment related symptoms. This is called palliative care. The care is focused on the whole person, not just the illness. The program is dedicated to helping individuals and families, in partnership with their physician, live well with a serious, life-limiting illness.

Transitions logo TagWhat does that really mean? When a patient is admitted into the Transitions Palliative Care Program, the care team becomes the patient advocate. The team partners with the patient’s attending physician for all health care decisions. The attending physician is free to focus on treatments and curative care while the palliative care team looks after the overall quality of life for the patient and family. This may include proactive symptom management such as identifying and addressing sources of pain or other discomforts like breathing difficulties, fatigue, insomnia, and more. Knowledge and expertise is also provided by a licensed clinical social worker. The social worker can help alleviate the immense stress family members and caregivers carry by providing psychological and emotional support. They also help link family members with a large array of community programs like Meals on Wheels, support groups, and paratransit services. The social worker can also help the patient and family set life goals. Additionally, the palliative care team can provide essential education specific to the illness or disease and its expected progression. By maintaining open and constant communication about the patient’s progress, families and caregivers are better equipped to handle what comes next with both patient care and critical decision making regarding treatment or care plans. The outcome of patient and family driven goals of care can result in a reduction of unwanted hospitalizations, making patient care easier, and providing a better overall quality of life.

Do you know someone who is dealing with a life-limiting illness and needs help obtaining information and understanding of their illness and its challenges? Or perhaps is having trouble managing the activities of daily life? The Transitions Palliative Care Program may be the answer. Criterion for admission is a diagnosis of illness with the prognosis of one year or less. Admission into the program does not require the patient to cease pursuing curative care. The program services are covered by most insurance programs. Most importantly, you have access to the patient’s case manager 24 hours a day, seven days a week. When critical questions or situations arise, you are one phone call away from a highly skilled healthcare professional, an experienced problem solver, and a passionate patient advocate.

For more information about the Transitions Palliative Care Program, call 530.272.5011 today. Find out if the program is the right step for you or someone you know.

The End of Life Option Act is Now Law

June 28, 2016

by Carolynn Peterson RN, MSN, AOCN, CHPCA, Executive Director

 Californians have been debating physician assisted suicide, euthanasia, right to die, and death with dignity for well over 20 years.  In 1997, Oregon, Washington, and Vermont were the first states to approve laws that supported a patient’s right to die.  With the governor signing Assembly Bill No. 15, End of Life Option Act, hospices across the state of California are deciding how they will respond.

California Hospice and Palliative Care Association came out with a Position Statement on Right to Die in March of 2015.  The statement reiterated the fundamental hospice philosophy; hospice values life and neither hastens nor prolongs the dying process.  Hospice organizations believe that people do have a right to self-determination, to excellent pain and symptom management, and a right to refuse unwanted medical intervention, allowing death to occur naturally.  When cure is no longer possible, hospice provides the essential knowledge and skills to support the patient and their loved ones, facilitating the relief of physical, emotional, and spiritual suffering for the terminally ill. Fortunately, the End of Life Option Act recommends attending physicians provide counseling on participation in a hospice program.   Encouraging patients to experience the compassionate comfort care provided by a highly skilled multi-disciplinary hospice care team provides patients with another option before making such a monumental decision.

So, what does that mean?  The legislation does not require health care providers to carry out a patients request pursuant to the End of Life Option law. In support of the hospice mission, Hospice of the Foothills will not participate in the decision or provide the life-ending medications. But, Hospice of the Foothills will not abandon the patients and families facing such a deeply personal choice. We will provide education and support to our patients and families even if the patient chooses to end their live.  Hospice of the Foothills will be there…before and after.

There are a wide range of views and perspectives in our society surrounding the ethical issue of deliberately ending life for a person living with a terminal condition.  These should be recognized and respected.  We believe declining or withdrawing treatment is acceptable when in alignment with the informed wishes of the patient. Informed wishes of a patient start with an honest conversation with their physicians, family members, and loved ones.

Hospice believes the experience of dying is a significant part of life.  The process of dying often leads to enhanced meaning and purpose and can be a sacred experience for the patient and family.

Hospice of the Foothills provides symptom management, pain relief, education, support, and comfort for our patients and their loved ones. For more information call 530-272-5739.      

All Hospices Are NOT The Same

June 7, 2016

Did you know hospice is a philosophy of care rather than a place? It’s not uncommon for people to think that all hospices are connected, but hospices from town-to-town and state-to- state are different entities.  Some are ‘for profit’, corporate run enterprises.  Others, like Hospice of the Foothills, are nonprofit organizations with a grass roots history in the community.

In October of 2014, Consumer Reports ran an article entitled “How to Find a Good Hospice Program.” The article advises readers to be wary since more than half of U.S. hospice programs are for-profit.  It then goes on to detail what to look for in a hospice:

  • Not-for-profit status and more than 20 years of experience. (Hospice of the Foothills was founded as a nonprofit organization in 1979).
  • Hospice-certified nurses and doctors on staff available 24 hours a day. (Hospice of the Foothills’ interdisciplinary team of hospice trained nurses, social workers, spiritual counselors, hospice aides and physical therapists is led by a Medical Director who is board certified in both Family Medicine and Hospice and Palliative Medicine).
  • Palliative-care consultants who can begin care if you’re not yet ready for hospice. (Hospice of the Foothills offers a fully staffed Transitions Program for people who have been diagnosed with a life limiting illness and has a prognosis of one year or less).
  • Ability to provide care in nursing homes and assisted living facilities. (Hospice of the Foothills serves nursing homes and assisted living facilities in Placer and Western Nevada Counties).
  • Social Workers and Chaplains. (Hospice of the Foothills’ spiritual counselors support patients and family members with any spiritual issues that might arise during this difficult time. Five medical social workers with master’s degrees provide assistance with end of life tasks, financial issues, and final arrangements).
  • Medicare approval. (Hospice of the Foothills is fully Medicare approved and certified).

At Hospice of the Foothills, our care teams are experts in providing high quality end-of-life care. Plans of care are individualized to each patient and family to ensure the needs of the whole family unit are addressed.  This may include volunteers to help with errands or provide respite time for family members.  Other things to consider are what programs and services are offered and whether they’re provided locally, such as patient and family education and bereavement support groups.  With over 37 years of experience, Hospice of the Foothills is uniquely able to draw upon the knowledge gained from serving thousands of patients and families in our community.  Hospice of the Foothills’ programs and services are all offered locally to meet the unique needs of our community’s terminally ill patients by providing continuous care and support through the patient’s death and the family’s bereavement period.

At Hospice of the Foothills we believe that every moment matters. If you have any questions or concerns about hospice care, or whether hospice is right for you or your loved one, please call us today at 530.272.5739.

Still Here and Going Strong

February 11, 2016

Hospice of the Foothills’ Board of Directors and executive leadership are committed to making sure our community has the highest quality end-of-life care now, and for many years to come. While we made the difficult decision to close our Compassionate Care Home, the 12-bed in-patient facility, our core business and mission is unchanged; caring for patients in their homes, or wherever they call home.

Since 1978, we’ve touched the lives of thousands of people.  A poignant way to convey the difference Hospice of the Foothills can make for patients and families is to share the following letter Executive Director Carolynn Peterson received from a family served by Hospice of the Foothills:

“As you may know, my mother and step-father were patients of Hospice of the Foothills recently.  I wanted to share a few thoughts with you regarding their care and express our considerable thanks to your staff.

Hospice was a word my mother and step-father originally feared. I believe they associated it with giving up, with death.  However, over the just twenty days of care for my stepfather and the five months of care for my mother, they both eventually understood that ‘hospice’ actually stands for compassion, for dignity, for comfort, and for a higher quality of life during one’s final journey.  From our initial meeting to the last moments with Mom five months later, the staff was there for them.

My stepfather was not a religious man. But in those final hours, as he held our hands, I believe he knew he was surrounded by earthly angels – the nurses and volunteers of Hospice of the Foothills.  Because of them he was able to let go of his fear and embark upon his final voyage peacefully and unafraid.  And, because of that, Mom was able to accompany him along that path within a place of warmth, comfort, and unwavering support.  As his final night fell and the soft lighting from the lamps chased the shadows from the corners, he traveled peacefully forward to places unknown without pain or fear.

Now, Mom did believe in a merciful God. She never professed to understand her lot in life, but accepted it with few questions and a love of life.  With the support of Hospice of the Foothills she maintained that toughness, that love, and that acceptance.  Your staff helped her to be herself to the end.  I was fortunate to spend the last few nights by her side, able to hold her hands, speak of our life together, smile and cry, knowing that she was in no pain – much of this I consider a gift from Hospice.

We are so grateful to have been blessed by all of the people who are Hospice of the Foothills. We can never adequately thank them for their skills, compassion, love, and tears they shared with us and our mom and dad”.

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