Professional Summary

Licenses Licensed Registered Nurse-Office of Professional Regulation, Illinois 1998

Skill Highlights

Trained in compassionate inpatient and outpatient hospice care

Professional Experience

April 2014 to Current Residential Home Health and Hospice Transition Nurse Liaison Elmhurst, Illinois Identified and evaluated patients for inpatient and outpatient hospice care. Acted as educator for hospital staff, physicians, families and patients regarding home health and hospice services. Assessed and admitted patients to inpatient hospice care. Performed daily inpatient hospice visits. Evaluated patients for home health and hospice services. Attended daily discharge planning rounds. Collaborated with social services, staff nurses, durable medical equipment companies, outpatient pharmacies and physicians to provide a safe transition to the home. Processed intake information in a timely manner. Coordinated care by communicating with assistant managers and scheduling.

July 2010 to September 2013 Elmhurst Home Health and Hospice Inpatient RN Liaison Elmhurst, Illinois The job responsibilities for this position are the exact same as they are for the Transition Nurse Liaison. Elmhurst Home Health has signed on to a joint business venture with Residential Home Health. As the transition continues the liaison role will change to meet the needs of the agency.

November 2013 to March 2014 Elmhurst Home Health and Hospice Hospice RN Case Manager (on light duty)/Assisted Quality Manager Elmhurst, Illinois Performed monthly clinical record reviews for home health and hospice. Assisted hospice manager with

Paula Gianatasio

1043 E Adams St, Lombard, IL 60148 Cell: 630-***-**** acegiv@r.postjobfree.com

Patient focused Registered Nurse with 16 years of experience in healthcare.

Compassionate Hospice Case Manager

Resourceful Discharge Planner for home health, hospice services and durable medical equipment

Creative problem solver

Demonstrated ability to collaborate care with a mutlidisciplinary team approach

Strong reputation for reliability and accountability

Expert in evaluating for home health and hospice services

Specialized in discharge planning

Experienced in triage

Skilled in behavioral health care

Self directed

Proficient chart auditor

Familiar with Medicare denials and appeals

Detail oriented

Committed to customer service

Demonstrated ability to multi-task

Effective patient and family educator

Meticulous with documentation

Working knowledge of assessment and treatment in behavioral health

evaluating documentation on new admissions to ensure compliance of quality standards. Completed a project designed to reduce home health acquired device related infections and establish agency standard of care by reviewing the methodology of PICC line documentation. Completed a study to ensure compliance in the use of inpatient hospice care per Medicare Hospice service requirements. Assisted Quality Manager with Medicare denials (ADRs), 1st Level Appeals (Redeterminations) and 2nd Level Appeals (Reconsiderations). Appointed as resource for third party consulting firm reviewing 22 Post Payment Additional Documentation Required medical records. Educated staff and physicians about Medicare requirements for face to face encounters and how to complete attestations when additional documentation was required.

October 2011 to March 2014 Elmhurst Home Health and Hospice Facility Liaison Registry Elmhurst, Illinois Performed in the role of Facility Liaison as needed for coverage during vacations for full time staff member. Maintained reliable communication with facility social services department and staff . Coordinated care for patients in skilled facilities at time of discharge. Assessed patient's needs and educated patient and families regarding community resources. Collaborated with skilled facility and coordinated care with home health, hospice and home medical equipment to ensure a smooth transition from facility to home.

December 2012 to September 2013 Elmhurst Home Health and Hospice Hospice Nurse Case Manager Elmhurst, Il Conducted initial comprehensive assessment to determine patient's appropriateness for hospice care. Educated patients and families regarding settings for care, insurance and Medicare coverage. Explained the interdisciplinary team approach to care and the philosophy of care versus cure. Evaluated patients' physical, emotional, spiritual and financial needs. Offered expert recommendations based on evaluation. Communicated effectively with agency, physicians, nursing home staff, durable medical equipment companies and agency pharmacy regarding patient's needs. Participated in weekly case conferences to collaborate and co-ordinate hospice care plan. Performed supervisory visits to oversee hospice aides and establish accountability for outcomes. Remained available to patients and families as needed to ensure their comfort. Performed death calls and post mortem care. Contacted funeral home and county coroner to report death. Remained with the family for emotional support and to answer questions.

October 2012 to September 2013 Elmhurst Home Health and Hospice Triage RN Elmhurst, Illinois Triaged incoming communications during normal business hours. Received inquiries regarding services available from outside sources. Evaluated calls from families and patients to determine best course of action. Communicated with field staff regarding patient and family concerns and collaborated with assistant managers and scheduling to ensure visits to patients that required same day assessments. Responsible for doctor's line to answer questions, take referrals and process orders. Assisted field staff with questions and concerns regarding their schedules and patients. Acted as intake responsible for outside referrals and processing them in a timely manner. Received lab results and alerted appropriate staff and physician to ensure follow up with new orders, medication adjustments and patient education. Identified home health patients admitted to hospitals and facilities and updated medical record and field staff accordingly. Responsible for insurance verifications on outside referrals.

September 2011 to October 2012 Presence Life Connections Post Acute Care Navigator Joliet, Il Served as initial contact for patients and families to coordinate post acute care services including palliative care, hospice care, private duty care, acute rehabilitative services, skilled nurse facility placement and assisted living referrals. Educated patients and families in disease management, treatment options and resources available to them. Served as a resource to staff and physicians in identifying appropriate after care. Consistently communicated with agency home health and hospice offices to ensure timely delivery of care. Collected

demographic information, orders, history and physical, labs and other documents associated with patient and faxed them to the intake department for processing. Acted as Discharge Advocate for a pilot project funded by Boston University called Project Red. Implemented Project Red, a re-engineered discharge planning process that focused on education, communication and close follow up as a means to decrease readmissions of patients with chronic conditions. Coordinated opportunities for pharmacy, dietary and nursing staff to educate patients and families regarding disease management and utilize the teach back method to evaluate their comprehension. Created a spreadsheet to track patient's progress and incidences of readmissions. Contacted patients in established time increments to determine compliance with physician appointments, diet and medications. Identified obstacles to care and collaborated with social services to assist patient with overcoming those obstacles.

Elmhurst Memorial Healthcare-Clinic Division March 2005 to July 2010 Clinical Coordinator Elmhurst, Illinois Managed day to day operations of a busy 3 physician outpatient pulmonary practice. Acted as triage nurse. Scheduled patient's visits. Collaborated with the physicians to adjust their schedules according to patient acuity. Planned patient care and implemented doctor's orders according to patient's needs. Managed routine medication refills, arranged home oxygen therapy and nebulizer machines and medications. Maintained professional rapport with outpatient pharmacies and durable medical equipment companies. Facilitated diagnostic testing, pulmonary rehab and physical therapy. Obtained authorizations for diagnostic tests and medications from insurance companies. Administered injections according to doctor's orders. Educated patients and their families on disease process and management. Maintained professional communication with staff, internal and external customers. Approved payroll bi-weekly. Performed annual reviews. Interviewed prospective candidates. Hired staff, provided adequate orientation and implemented disciplinary action according to human resource protocols.

Elmhurst Memorial Healthcare May 2000 to March 2005 Staff RN - Locked Psychiatric Unit Elmhurst, Illinois Participated in weekly staffings with a multidisciplinary team to discuss discharge plans for assigned patients. Performed thorough intake evaluations and admission assessments. Assisted Emergency Department staff by assessing patients to determine appropriateness for inpatient vs outpatient behavioral health care. Contacted insurance companies to obtain precertifications. Delivered comprehensive nursing care to patients in an acute care psychiatric milieu. Collaborated with the healthcare team including psychiatrist, social worker, mental health associate and activity therapist daily to plan patient care and set therapeutic goals. Participated in family meetings. Educated patient and their families regarding disease processes and treatment options. Prepared, monitored and recovered patients through Electroconvulsive Therapy. Witnessed mental health court. Acted as charge nurse.

Elmhurst Memorial Healthcare September 1998 to May 2000 Staff RN-Med/Surg Elmhurst, Illinois Collaborated comprehensive nursing care with a multidisciplinary team on a medical/surgical unit. Cared for patients pre and post operatively. Performed complex dressing changes. Started and maintained IV's including site care. Transfused blood products. Cared for central lines, PICC lines and port-a-caths. Inserted and discontinued nasogastric tubes and foley catheters. Meticulously documented in patient's medical record. Alerted charge nurse and physician of any changes in patient's condition. Precepted and mentored new graduates. Demonstrated critical thinking through prioritizing complex care. Acted as patient advocate. Acted as charge nurse.

Education and Training College Of Dupage 1998 Associate of Science: Associate Degree in Science Nursing

Glen Ellyn, Illinois, USA CPR Certified End of Life Trainer 2012 Currently enrolled at University of Phoenix with 5 more classes to complete my BSN

Awards Certificate of Clinical Excellence 2010 Nursing Recognition and invitation to Recognition Breakfast with Vice President of Clinical Operations 2013

Committees/Councils Central Intake Committee 2013 Co-chairman of Work/Life Council 2013 Project Red Committee 2011 Board Member of Leeza's Place 2011

References Available on request

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