Quality Assurance Manager
Resume:
TANYA MIKESELL R.N.
•
• **** Klatte Rd.
• Cincinnati, Ohio 45244
• Email: ********.*****@*****.***
OBJECTIVE
Through the evolution and success of my career I am seeking a position where I can utilize my experiences to assist
facilities grow and achieve optimal quality of care.
Experience
March 2012 – to present
Director of Health Services Twin Towers Cincinnati, Ohio
• Successfully establish culture change in an inter-city building
• Implemented, Person-Centered Care
• Developed and implemented Nursing Rehabilitation Unit
• Assisted in the Corporate Marketing Plan – to improve community and referral relationships
• Acquired relationships with ACO – (accountable care organization) with local hospitals, thereby selected for
preferred provider list
• Collaboratively negotiated insurance contracts – RFP (request for proposal)
• Transitioned all nursing staff to a new building
• Strategic initiative team participant - develop risk management team for facility as well as part of risk
management team for area LTC facilities.
• Improved QAA process by utilizing metrics and root cause analysis
• Reduced agency utilization from 87% to < 25%
November 2011-March 2012
Director of Nursing Fountain Circle Winchester, KY
• Achieved successful survey results, One of two necessary for removal from Focused Facility list
• Developed and implemented Transitional Care Unit
• Successful recruitment of nursing staff preventing the utilization of agency staff
September 2007 – November 2011 BCC Newport, KY
Director of Nursing
• Removal from Focused Facility list by achieving consecutive deficiency free surveys
• Established and implemented QA program that significantly reduced restraints to <3% and 0 “in-house”
pressure ulcers for 4 consecutive months. (ongoing)
• Worked collaboratively with OIG and Healthcare excel to improve quality assurance
• Recruitment and Retention of nursing staff thereby reducing staff turnover by 66%
• Introduced Resident Centered Care and Culture Change
• Established T E C H groups for teambuilding
• Achieved 5 Star rating on NHQI - June 2010 to October 2010
October 2005 – February 2007 NCM Cincinnati, Ohio
Director of Nursing
• State Regulatory compliance, resulting in deficiency free survey
• Established new sub acute/rehabilitation floor
• Recruitment retention approx. 83%, resulting in maintaining agency free
• Worked collaboratively with MDS to increase case mix score
• Established skin program to reduce pressure ulcers, to 0 in house acquired.
• Decreased overall restraints in facility to less than 3%.
• Coordinate and oversee multidisciplinary team to ensure we are meeting
• Established rehab goals and time lines.
• Interview, hire, orient, evaluate and provide ongoing clinical support to allNursing staff.
• Assist with new resident admissions and coordinate all care needs
• Provide back up support for patient care when scheduling conflict arises
• Strong clinical resource for field staff with troubleshooting & problem solving
• Maintaining & establishing rapport with physicians and referral sources.
January 2005 – October 2005
Corporate Consultant
• Developed new business as regulatory compliance consultant for homecare companies.
• Educated staff
• Initiated JCAHO
• Successfully established processes/programs to gain/maintain compliance
• Instructed management staff how to develop an action plan
• Composed a performance improvement program
• Maximized case mix to balance patient care and profitability
March 2003-January 2005 HCR Manorcare Woodside Madeira, Ohio
Interim Director of Nursing – (October 2004 –January 2005)
• State Regulatory compliance, resulting in defiency free surveys and JCAHO accreditation acquisition.
• Successfully recruited/retained nursing staff to eliminate agency from facility.
• Educated nursing staff for higher level acuity resident/patient care.
• Developed the transitional care unit to increase revenue
• Established skin program to reduce pressure ulcers
• Successfully reduced/eliminated the use of restraints
Assistant Director of Nursing (July 2003-October 2004)
Assigned to oversee a 155 bed capacity facility
• Converted long-term wing into a TCU (Transitional Care Unit)
• Coordinate/Negotiate transfer of long-term residents to other units
• Develop, educate and mentor staff to reorganize and appropriately prioritize their day to account for increased
acuity
•,Weekly rounds with Physiatrist
• Coordinate and oversee multidisciplinary team to ensure we are meeting established rehab goals and
timelines
• Interview, hire, orient, evaluate and provide ongoing clinical support to all nursing staff.
• Recruitment and retention of nursing staff
• On a weekly basis meet with new hires to educate them on Infection Control Program/Policies that have been
established by HCR Manorcare
• Resource for troubleshooting and problem solving facility and resident needs
• Clinical Triage for medically complex residents
• Attend daily multidisciplinary team meetings to discuss resident’s care, changes in status then follow-up with
the resident, caregivers and MD as needs/concerns are identified
• Skilled in IV access which includes peripheral IV, midlines, PICC’s, C-line, jugular and port-a-cath’s
• Round daily to meet with resident’s to evaluate status and follow-up on concerns
• Assist with acceptance of all new residents who request admission to facility
• Assist with new resident admissions and coordinate all care needs
• For assigned units manage, track weekly all skin conditions/ pressure areas and prepare weekly reports for the
Director of Nursing
• Oversee Infection Control Program and provide monthly Quality Assurance Report
• Prepared for and participated in our deficiency free Annual State Survey in March 2004
• Provide back-up support for patient care when a scheduling conflict arises
• Provide back-up coverage for other unit managers
• Work with corporate consultants for implementation of new programs
Regional Case Manager – Discharge planning/ Homecare (March 2003-July 2003)
• Case Management of all insurance admissions to 4 Manor Care Extended Care facilities
• Clinical liaison to determine placement and appropriateness of each Insurance referral
• Upfront benefit verification, negotiations, review of each resident’s specific needs to determine if per diem
amount is appropriate to manage residents care. If determined that they have a higher acuity, and additional
funds are necessary to manage care, then would request a carve out and negotiate rates
• Monthly review and audit of UB92’s prior to billing to assure appropriately requesting reimbursement
• Ongoing case management of Insurance residents providing updates to the insurance companies and
coordinating updates to the multiple disciplines at each facilitate discharge plans
• Monthly review of all reimbursed insurance cases to determine if paid appropriately, if issue, then would review
to determine what changes needed to occur, then would resubmit and file for appeal if needed
June 2001- March 2003 Option Care Milford, Ohio
Case Manager – Home care
• Process new patient referrals, work with pharmacist to evaluate patient’s needs and communicate those to all
parties involved with the patient’s admission
• Maintain and establish rapport with Physicians and referral sources, i.e. BMT unit, Oncology Care, UC Cystic
Fibrosis Clinic
• Strong clinical resource for field staff with troubleshooting and problem- solving
• Back up for clinical visits in the field i.e. challenging IV insertions, blood and platelet transfusions, support field
supervisors with mentoring new staff
• Supports and provides backup coverage for Clinical Liaison
• Excel in customer service skills, establishing and maintaining key relationships in the community
• Maintain and monitor authorizations with Insurance companies when applicable
Jan 2001-Mar 2001 Easter Seals S.W. OH Cinn, Ohio
Director of Children’s Services - Integrated Home care
• Developed inclusive daycare program
• Established facility as a waiver provider
• Increase revenue with programs developed i.e. ancillary services
• Summer camp
• Developmental play groups
Oct 1999 –Jan 2001 Pacific Care of Ohio Cinn, Ohio
Case Manager –Home care
• Case managed adult and pediatric cases
• Responsible for coordination of benefits, services and clinical management of Bone Marrow Transplants for
both adult and pediatric cases
• Coordinated services for Bone Marrow cases when out of area services were ordered
• Minimized cost per utilization review up to 25%
• Streamlined high-risk pregnancy program
Aug 1994-Aug 1999 MCH Services Cinn, Ohio
Assistant Director of Nursing – Home care
• Acted as Interim Director as well as Clinical Administrative Liaison
• Developed and refined multiple programs such as : New Graduate Program, IV class, Ventilator In-service,
Asthma Program, Nurse Orientation, On-call and Primary Nurse Programs
• Developed quality assurance performance improvement program, becoming JCAHO certified ODHS survey
compliance
• Revised policy and procedures, implemented revisions, educated staff and monitored accountability
• Responsible for recruitment and retention of field staff
• Developed branch budget and responsible to monitor adhering to budget
• Clinical care manager
Oct 1991-Dec 1994 CHMC Cinn, Ohio
Staff Nurse, Charge Nurse
ER Airway Management Unit, MED/SURG Unit
• Management of chronic care clients
• Worked with pre and post Bone Marrow Transplants for stem cell harvesting, pre induction chemotherapy,
airway management
• Airway management certified
• Educator for orthopedic care
• Practice council co-chairperson
• Established and implemented shared governance for orthopedic unit
EDUCATION
1987.1990 - Good Samaritan Hospital School of Nursing
1987-1990 - Diploma of Nursing
Currently Enrolled for completion of BSN
TECHNICAL SKILLS
Microsoft office
Excel
Word
PowerPoint
Internet Access
ECS
PCC (point click care)
AOD (access on demand)
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