NewProgram Manager II - Contract TalentBurst, Inc.Program Manager II - ContractCleveland, OHThe site currently does not have a formal 5S system in place and is targeting a full, structured 5S implementation within a six-month timeline, followed by focused stabilization, sustainment, and capability transfer. A key responsibility of the role is to prepare and transition long-term ownership of 5S sustainment to a designated site specialist or junior engineer before the end of the assignment.
Merchandise Coordinator Supervisor HomeGoodsMerchandise Coordinator SupervisorAvon, OH$14.50–$15 / hourCommunicates accurately and effectively with management and Associates when setting and addressing priorities; provides progress updates. Ensures an excellent customer experience by engaging and interacting with all customers, and maintaining a clean and organized store.
NewTransportation Supervisor SyscoTransportation SupervisorCLEVELAND, OHCoordinates efforts with the Safety department to aid in training, conducting associate observations, up-dating preferred work methods, conducting accident investigations to determine root causes and routine safety inspections. Exhibit knowledge of spreadsheet software and Word Processing software, and ability to learn Sysco technology software and programs.
NewProgram Manager SmartStart Education, LLCProgram ManagerCleveland, OHThis individual plays a critical role in maintaining exceptional instructional quality, supporting academic staff, and building trusted partnerships with school leaders. The ideal candidate has experience in classroom instruction and program implementation, excels at relationship management, and is passionate about improving student outcomes through high-quality educational programming.
NewHourly Supervisor - Cleveland State University Management Fee AramarkHourly Supervisor - Cleveland State University Management FeeCleveland, OHBENEFITS: Aramark offers comprehensive benefit programs and services for eligible employees including medical, dental, vision, and work/life resources. Supports and implements training programs that develop skills to better serve guests, build repeat business, grow revenue, and improve morale.
NewSupervisor - Lutheran Hospital - Cleveland Clinic AramarkSupervisor - Lutheran Hospital - Cleveland ClinicCleveland, OHSupervise and participate in the production, preparation, and presentation of all foods for unit(s) as assigned by the Aramark Executive Chef to ensure that a consistent quality product is produced. ? BENEFITS: Aramark offers comprehensive benefit programs and services for eligible employees including medical, dental, vision, and work/life resources.
NewConcessions Supervisor - Cleveland State University AramarkConcessions Supervisor - Cleveland State UniversityCleveland, OHThe Concessions Supervisor is responsible for the oversight or delegation of responsibilities within the food service operation such as inventory, customer service, food preparation, and food safety and sanitation procedures Essential functions and responsibilities of the position may vary by Aramark location based on client requirements and business needs. BENEFITS: Aramark offers comprehensive benefit programs and services for eligible employees including medical, dental, vision, and work/life resources.
Registered Nurse (RN) - Case Manager, Hospice - $70K-90K per year Elara CaringRegistered Nurse (RN) - Case Manager, Hospice - $70K-90K per yearWilloughby, OH$70,000–$90,000 / yearAssesses hospice care patients and families to identify the physical, psychosocial, and environmental needs of patients as evidenced by documentation, clinical records, Interdisciplinary Team reports, after hours reports, and on-site evaluations. As a Registered Nurse Case Manager, you’ll contribute to our success in the following ways: Ensures that all activities performed align with the vision of Elara Caring’s board of directors, executive team, and the leadership of the Hospice team.
Program Clinical Supervisor Bellefaire JCBProgram Clinical SupervisorShaker Heights, OHFull timeMonitor delivery of care by completing client rounds, documenting treatment progress, intervening to overcome deviations in the expected treatment plan, reviewing the treatment plan with clients and family in conjunction with the direct care providers, interacting with involved departments to negotiate and expedite services, reporting personnel and performance issues to the unit director, and maintaining ongoing communication with staff regarding the treatment plan and discharge plan. Develop interdisciplinary treatment plans and coordinate treatment across all treatment professionals by utilizing case management tools, coordinating information and care requirements with other care providers, resolving issues that could affect smooth care progression, and providing education to others regarding the case management process.
Program Floor Supervisor - 3rd shift Bellefaire JCBProgram Floor Supervisor - 3rd shiftShaker Heights, OHFull timeBellefaire JCB is a partner agency of the Wingspan Care Group, a non-profit administrative service organization providing a united, community-based network of services so member agencies can focus on mission-related goals and operate in a more cost-effective and efficient manner. The Program Floor Supervisor’s responsibilities include, but are not limited to, the administrative supervision of direct care staff, maintaining an effective therapeutic milieu, and ensuring that the program meets the client’s basic mental, physical, and emotional health, as well as their therapeutic, developmental, academic and recreational needs.
Program Floor Supervisor Bellefaire JCBProgram Floor SupervisorShaker Heights, OHFull timeBellefaire JCB is a partner agency of the Wingspan Care Group, a non-profit administrative service organization providing a united, community-based network of services so member agencies can focus on mission-related goals and operate in a more cost-effective and efficient manner. The Program Floor Supervisor’s responsibilities include, but are not limited to, the administrative supervision of direct care staff, maintaining an effective therapeutic milieu, and ensuring that the program meets the client’s basic mental, physical, and emotional health, as well as their therapeutic, developmental, academic and recreational needs.
Group Home Program Supervisor SevitaGroup Home Program SupervisorCuyahoga Falls, OH3. Medications: When applicable, accurately administers or supports self-administration of medication and documents delivery of medications and treatments; reviews all other medication documentation for accuracy and completeness, daily or weekly as required; reviews medication errors with employees; communicates medication changes and provides training across all shifts; maintains appropriate security of medications and supplies. Vehicles: When applicable, test drives vehicle monthly; inspects vehicle lifts and seatbelts monthly; reports safety concerns immediately to supervisor or maintenance personnel; assures vehicle is washed and cleaned; trains staff in safe vehicle operation and safely transporting individuals; ensures routine maintenance is performed.
Management Training Program Operations Supervisor ArcBest CorpManagement Training Program Operations SupervisorCleveland, OHt Requirements\t EducationBachelor\s Degree Business Supply Chain Management or related field preferredComputer SkillsProficient in Microsoft Office Suite requiredAdditional RequirementsGeneral knowledge of freight imports exports and proper freight handling techniques preferredMust be willing to relocate requiredCompetenciesActive LearningCustomer FocusEffective CommunicationsProblem SolvingSolutions and Services\t Other Details Work HoursSchedule may vary depending on Service Center location. With over a century of experience 240 service centers spanning North America and an unwavering commitment to quality safety and customer service ABF offers best-in-class LTL transportation for companies of all sizes and industries.
Clinical Program Manager - Residential Applewood CentersClinical Program Manager - ResidentialCleveland, OHFull timeDevelops and maintains collaborative and cooperative professional relationships with all levels of internal staff members, including Residential Services, Health Clinic, Environmental Services, Maintenance, Food Services, Clinical Services, Support, and Agency staff in other Divisions. Under the direction of the Director of Residential Services and in collaboration with the Program Supervisor, the Clinical Program Manager takes primary responsibility for supervising, planning, organizing, coordinating, and implementing all clinical aspects of programming.
["Air Ambulance Clinical Supervisor (Contract/Per Diem)","Air Ambulance Clinical Supervisor (Contract/Per Diem)"] Aery Aviation["Air Ambulance Clinical Supervisor (Contract/Per Diem)","Air Ambulance Clinical Supervisor (Contract/Per Diem)"]ClevelandLicensed as a Registered Nurse (RN) in the State of Ohio with an unrestricted license in good standing, orlicensed as a Paramedic with a current and valid Ohio certificate to practice under ORC Chapter 4765; multi-state licensure strongly preferred given interstate transport operations. Maintains documentation of all Clinical Supervisory activities — including training records, competency evaluations, QA/QI findings, and corrective actions — in a manner consistent with applicable record retention requirements and accreditation readiness.
Licensed Clinical Supervisor: Crisis Response Applewood CentersLicensed Clinical Supervisor: Crisis ResponseLorain, OHUnder the supervision of the Mobile Response Stabilization Program Manager, the Licensed Shift Supervisor will take and assign crisis calls from the 24/7 hotline to have clinicians respond face to face (in person or via video conferencing) to high risk crisis situations within an hour to assess the youth and stabilize the family. Applewood Centers, Inc. ("Applewood") is a private, nonprofit agency providing mental health services, social services and education to children, adolescents and families living in Cuyahoga and Lorain counties.
In-Home Clinical Supervisor Applewood CentersIn-Home Clinical SupervisorCleveland, OH$68,000–$72,000 / yearUtilize the MST and MST PSB treatment model, provide clinical supervision to staff during weekly team meetings, weekly consultation and individual clinician development supervision as needed, including attending home visits, court or other related meetings with staff. The MST/PSB Clinical Supervisor will provide limited direct services to MST clients, as the teams build, through direct delivery of intensive in-home services to youth and their families via use of the Multisystemic Therapy model.
Assistant Cottage Supervisor - Residential Applewood CentersAssistant Cottage Supervisor - ResidentialCleveland, OHFull timeMonitor the process whereby all basic needs of children/youth are consistently met (medical, dental, dietary, clothing, safety, clients rights and education) and makes necessary adjustments when barriers or problems arise. You will also provide hands on and administrative supervision including scheduling, training and performance management to ensure a high quality Treatment Specialist team provides the best care to our clients.
Ohio Rise: Clinical Supervisor Wingspan Care GroupOhio Rise: Clinical SupervisorLorain, OHApplying the principles of Systems of Care, the Supervisor of OhioRISE Care Coordination is responsible for developing and overseeing a team of Care Coordinators who ensure and cultivate flexible, family-focused, community-based responsive services based on the High-Fidelity Wrap Around Model of care coordination for Tier II Moderate clients and Tier III Intensive clients in alignment with The Wingspan Care Groups Mission, Vision and Core Values. Wingspan Care Group ("Wingspan") is the not-for-profit parent company of Applewood Centers, Inc., Bellefaire Jewish Children's Bureau, Bluestone Child & Adolescent Psychiatric Hospital, and Lifeworks.
Program Manager Case Western Reserve UniversityProgram ManagerCleveland, OHThis includes Case CCC sponsored conferences and symposiums, visits by NIH and other funding agencies, internal and external advisory boards, scientific seminars and scientific review sessions, Case CCC Seminar Series, programmatic retreats and support for the Case CCC leadership team. University: Daily contact with other university administrative areas and centers at all levels for overall operational functioning of the center including but not limited to; School of Medicine-based offices such as Human Resources, Faculty Affairs, and Central Payroll or University Technology.
Cottage Supervisor - Residential Applewood CentersCottage Supervisor - ResidentialCleveland, OHFull timeEnsure completion of all program documents including shift reports, floor plans, shared room contracts, monthly personal care progress notes, outing supervision forms, bedtime logs, milieu progress notes. Under the supervision of the Program Supervisor, the Cottage Supervisor provides oversight of programming, leadership, case management, and supervision of all activities and program staff (Treatment Specialists) assigned to a Residential Treatment Program.
Hospice RN Clinical Supervisor Ohio Living Home Health & HospiceHospice RN Clinical SupervisorGreater Akron, OHSupervises the implementation of the physician ordered hospice plan of care, by coordinating, auditing, overseeing, integrating, and modifying the IDG resources necessary to reach desired outcomes. Evaluates the effectiveness of the plan of care for hospice care delivery and collaborates with hospice clinical supervisors and hospice staff on best practice and desired outcomes.
Aerospace Program Manager Crane Co.Aerospace Program ManagerElyria, OHSkills/Abilities: Excellent Leadership Skills, Results Focus, Customer Service Orientation, Action Orientation, Planning & Organizing, Teamwork & Cooperation, Business Acumen, Decision-Making Skills; Proficiency in Microsoft Project and other PC based office tools. Program management responsibilities extend from customer proposal to program inception, through the successful transition to production processing after completion of qualification testing / certification compliance and production readiness reviews.
School and Community Based Clinical Supervisor Applewood CentersSchool and Community Based Clinical SupervisorLorain, OHFacilitates therapists' acquisition of skills for delivery of mental health assessment, behavioral health counseling and therapy, school and community based consultation, education and prevention services as well as staff implementation of selected evidence based treatment models. Monitor and facilitate staff development of skills and delivery of the mental health assessment, counseling/therapy, consultation, education and prevention services as well as selected empirically based models of treatment (and other program services as assigned).
Program Manager II TalentBurst, Inc.Program Manager IICleveland, OHThe site currently does not have a formal 5S system in place and is targeting a full, structured 5S implementation within a six-month timeline, followed by focused stabilization, sustainment, and capability transfer. A key responsibility of the role is to prepare and transition long-term ownership of 5S sustainment to a designated site specialist or junior engineer before the end of the assignment.
Clinical Supervisor (Psychologist) Applewood CentersClinical Supervisor (Psychologist)Cleveland, OHFull timeUnder administrative and clinical supervision of the Psychology Training Director/Director of Outpatient Services, the Supervising Psychologist provides guidance, instruction and direct supervision to assigned outpatient therapists, psychology APA Interns, Psychology Post Docs and psychology practicum students (and, by assignment, staff from other programs). In cooperation with the Psychology Training Director/Director of Outpatient Services participate in Internship Committee activities including recruitment, evaluation, committee meetings and APA site visits.
Sr Program Manager- Aerospace Crane CoSr Program Manager- AerospaceElyria, OHSkills/Abilities: Excellent Leadership Skills, Results Focus, Customer Service Orientation, Action Orientation, Planning & Organizing, Teamwork & Cooperation, Business Acumen, Decision-Making Skills; Proficiency in Microsoft Project and other PC-based office tools. Program management responsibilities extend from customer proposal to program inception, through the successful transition to production processing after completion of qualification testing/certification compliance and production readiness reviews.
Clinical Supervisor Life Anew Behavioral HealthClinical SupervisorEuclid, OhioWill be assigned to one of the following departments: Direct Service, Day Treatment, Therapeutic Behavioral Services, SUD Services, Group Therapy. We provide quality and holistic mental health services, to ensure that clients are effective and productive in their daily lives.
Program Manager- Aerospace Crane Aerospace & ElectronicsProgram Manager- AerospaceElyria, OHSkills/Abilities:ExcellentLeadershipSkills,Results Focus,Customer Service Orientation,Action Orientation, Planning & Organizing, Teamwork &Cooperation,Business Acumen,Decision-Making Skills;Proficiencyin Microsoft Project and other PC based office tools. Beyond an associate’s base compensation, we reward and reinforce wellbeing with a compelling package of both cash and non-cash benefits, including comprehensive health, wellness incentives, assistance with retirement savings, paid time off, paid holidays, and tuition reimbursement — as well as performance-based bonus programs for certain positions.
In-Home Therapist Supervisor Bellefaire JCBIn-Home Therapist SupervisorLorain, OHBellefaire JCB is a partner agency of the Wingspan Care Group, a non-profit administrative service organization providing a united, community-based network of services so member agencies can focus on mission-related goals and operate in a more cost-effective and efficient manner. Develop a collaborative working relationship with the Lorain County Network of 4-C, Mental Health providers, Children's Services, Court & Substance Abuse Services and facilitate coordination of care for clients within these entities.
Hospice RN Clinical Supervisor Ohio Living Home Health & Hospice - Greater AkronHospice RN Clinical SupervisorFairlawn, OHSupervises the implementation of the physician ordered hospice plan of care, by coordinating, auditing, overseeing, integrating, and modifying the IDG resources necessary to reach desired outcomes. Evaluates the effectiveness of the plan of care for hospice care delivery and collaborates with hospice clinical supervisors and hospice staff on best practice and desired outcomes.
Emergency Veterinary Clinical Supervisor MedVetEmergency Veterinary Clinical SupervisorAkron, Ohio$26.50–$36 / hourOur Emergency team is the perfect place for technicians who thrive in a fast-paced environment, can shift gears quickly and handle the stress of critical situations with ease. Manages early call-ins, early departures, call-offs, sharing of resources, breaks and lunches for team members .
Program Manager II TechDigital CorporationProgram Manager IICleveland, OHResponsibilities:Job Title: 5S FacilitatorAssignment Duration: 6 months________________________________________Position SummaryThe 5S Facilitator is a temporary, site-based role responsible for leading the end-to-end implementation of the 5S methodology across the facility. A key responsibility of the role is to prepare and transition long-term ownership of 5S sustainment to a designated site specialist or junior engineer before the end of the assignment.________________________________________Key
Supervisor, Nursing-Psychiatry Signature Health IncSupervisor, Nursing-PsychiatryMaple Hts., OHEffectively supervise and oversee the daily objectives of the Addiction Services nursing team including, but not limited to, ensuring patient's timely access to services, buprenorphine/LAI MAT injectable induction, individual census reconciliation, staff productivity, efficient and organized communication with treatment team members, and thorough documentation. Support the Nursing Director in developing and implementing metrics for monitoring program effectiveness, maintain clinical protocols to support an evidenced based patient care delivery model, care coordination, and quality improvement efforts.
Program Operations Manager Case Western Reserve UniversityProgram Operations ManagerCleveland, OHCreate operational capacity for executive directors and center leaders by managing administrative processes, stakeholder communications, scheduling, reporting, participant records, follow-up activities, and other operational functions necessary for effective center management. The position enables Center leadership to focus on external engagement, partnership development, fundraising, and strategic growth by ensuring programs, systems, communications, and operational processes are executed effectively and consistently.
Lab Supervisor - Auto-Chemistry Quest Diagnostics IncLab Supervisor - Auto-ChemistryCleveland, OHMaintain laboratory areas and equipment in a safe, functional, and sanitary condition • Complete training and competency checklists as appropriate • Adheres to all established CLIA, HIPAA, OSHA, and laboratory safety requirements • Required to use personal protective equipment, engineering controls, and/or work practice controls as directed by management • Answer questions from clients or other lab personnel if applicable • Participate in government or regulatory agency inspections if needed • Other duties as assigned. Skills: • Proven leadership and problem-solving skills • Must be detail-oriented, have the ability to work independently, establish work priorities, and handle several tasks simultaneously for maximum department efficiency • Interpersonal and communication skills necessary to deal courteously and effectively with employees, co-workers, and clients • Ability to deal with client information in a confidential manner • Proficiency in Microsoft Office, Word, Excel, and Outlook, and Laboratory Information Systems.
RN Nursing Supervisor NewVista Behavioral HealthRN Nursing SupervisorLorain, OhioAt New Vista, our passionate and highly trained team of professionals inspires hope and delivers holistic care to those in need of behavioral health services in a contemporary and healing environment – one that is conducive to providing the life skills needed to regain stability and independence. With a blend of group therapy, clinical treatment, and unique surroundings, our beautiful healthcare centers provide a safe, serene, healing environment for adults and seniors with a variety of complex needs.
Caregiver Supervisor (LPN), ElderOne (Full Time, Eveings) Rochester Regional HealthCaregiver Supervisor (LPN), ElderOne (Full Time, Eveings)Hudson, Ohio$26–$35 / hourThe Supervisor Caregiver (at ElderOne or CNA at LTC services supervises the staff to ensure regulatory compliance and quality while maintaining an optimal level of independence for the enrolled frail elderly participants. M - Medium Work- Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.
Supervisor, Nursing Community Signature Health IncSupervisor, Nursing CommunityBeachwood, OHReporting to the Director, RN Operations Addiction Medicine, the Supervisor, Community Nursing provides oversight, direction, and leadership of the community nursing team while ensuring high-quality and patient-centered care is received by patients and their families. Effectively supervise and oversee the daily objectives of the Community Nursing team including, but not limited to, ensuring timely access to services, comprehensive assessment, individual census reconciliation and tracking, staff productivity, efficient and organized team communication, and thorough documentation.
LPN - Part Time, New Incentive Program!! PACS Group IncLPN - Part Time, New Incentive Program!!Mentor, OHDevelop and maintain a good working rapport with inter departmental personnel, as well as other departments within the facility to ensure that nursing services and activities can be adequately maintained to meet the needs of the residents. Assist the Director and/or Infection Control Coordinator in identifying, evaluating, and classifying routine and job related functions to ensure that tasks in which there is potential exposure to blood/body fluids are properly identified and recorded.
LPN - Full Time, New Incentive Program!! Nights Available!! PACS Group IncLPN - Full Time, New Incentive Program!! Nights Available!!Mentor, OHDevelop and maintain a good working rapport with inter departmental personnel, as well as other departments within the facility to ensure that nursing services and activities can be adequately maintained to meet the needs of the residents. Assist the Director and/or Infection Control Coordinator in identifying, evaluating, and classifying routine and job related functions to ensure that tasks in which there is potential exposure to blood/body fluids are properly identified and recorded.
IT Transformation Program Manager Expert In Recruitment SolutionsIT Transformation Program ManagerWestfield Center, OHDemonstrated experience partnering closely with senior IT executives (CIO, CTO, enterprise architecture, infrastructure, and application leaders) to define strategy and translate it into actionable roadmaps. The Enterprise IT Transformation Program Manager is responsible for leading and orchestrating a complex, multi-workstream transformation program (e.g., Expense Management, Operating Model, and related initiatives).
Unit Supervisor (RN) Kingston Health Center of VermilionUnit Supervisor (RN)Vermilion, OhioFull timeGET IN TOUCH: Morgan (419) 933-8856 LIFE AT TRILOGY: Whether you’re looking for a new chapter, a change of pace, or a helping hand, Trilogy is committed to being the best place that you’ve ever belonged. The Unit Supervisor fosters a collaborative work culture, facilitates communication with residents, families, and surveyors, and ensures goals related to care quality, resident satisfaction, and staff retention are met.
Supervisor, Behavioral Health Services Signature Health IncSupervisor, Behavioral Health ServicesWilloughby, OHServe as a role model for safe and effective crisis management by actively responding to crisis situations, adhering to agency emergency protocols, and educating staff on safety protocols and best practices for crisis intervention. Reporting to the Manager, Behavioral Health Services, the Supervisor, Behavioral Health Services will provide oversight and clinical direction for a team of treatment providers including counseling, case management and peer support professionals.
Nursing Supervisor - Inpatient Surgery - Allen Hospital Bon Secours Mercy Health IncNursing Supervisor - Inpatient Surgery - Allen HospitalOberlin, OHMercy Health seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive. Performs limited managerial responsibilities and works on ground support for frontline staff and assists in direct patient care as needed.
Clinical Supervisor - LISW-S Minority Behavioral Health GroupClinical Supervisor - LISW-SAkron, OhioThe clinical supervisor is a management level position that works in cooperation with the Clinical Director and is responsible for the Supervision of up to six (6) therapists and/or CPST Providers. The clinical supervisor is in good standing with their current case loads and job responsibilities including the accuracy and timeliness of submitting clinical documentation.
House Supervisor - Nightshift Ernest HealthHouse Supervisor - NightshiftAkron, OhioFull timeJoint Commission-accredited and certified in stroke and brain injury rehabilitation, Summa Rehab Hospital is nationally recognized (including being named one of America’s Best Rehab Hospitals by Newsweek) for delivering patient-centered care that helps individuals regain independence. Summa Rehab Hospital in Akron, Ohio (a partnership with Summa Health) is a state-of-the-art inpatient rehabilitation facility dedicated to helping patients overcome disabling injuries and illnesses.
Supervisor Nursing - Med Surg 4W - Lorain Hospital Bon Secours Mercy Health IncSupervisor Nursing - Med Surg 4W - Lorain HospitalLorain, OHMercy Health seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive. Certifications required based on the unit(s) that the leader oversees and the requirements for those specific units: PALS Pediatric Advanced Life Support (preferred).
Senior Community Disaster Program Manager American Red Cross Blood ServicesSenior Community Disaster Program ManagerCleveland, OH$89,000–$91,920 / yearRegional positions: Regional leadership and functional employees are expected to work daily within their region's geographic area to provide leadership and functional support, engage and mobilize communities, and support volunteers. AmeriCorps, the federal agency that brings people together through service, and its partners - the Peace Corps, AmeriCorps Alums, National Peace Corps Association, and the Service Year Alliance - launched Employers of National Service to connect national service alumni with opportunities in the workforce.
Nursing Supervisor (RN) - PRN Night Shift Crystal Clinic Orthopaedic CenterNursing Supervisor (RN) - PRN Night ShiftFairlawn, OHResponsible for assuming on-site supervision for the continuum of care within nursing on evenings and night shifts, including resource allocation with the units, facilitation of patient flow, assurance of quality care, clinical and departmental problem solving and communication with the administrator on call when appropriate. Coordinates patient throughput across the continuum encompassing all departments to provide efficient and effective quality patient care; Facilitates timely discharge of patients with declining medical status with admission to a facility with a higher level of care.