Home Health Nursing

LAURA S. MONTALVO, RN, BSN, COS-C, HCS-D

***** ******* *****~ SA, TX 78247~ ***************@*****.***~210-***-****

OBJECTIVE

Position Desired: Progressive Clinical Leadership/Quality nursing position in a home health and hospice environment that provides superior clinical care utilizing leading technology solutions.

SUMMARY OF QUALIFICATIONS

Over 15 years of nursing executive leadership experience emphasizing a decisive yet team oriented style. Executive clinical leadership roles include: Chief Clinical Officer (CCO), Corporate Director of Nursing of multi-line/multi-site home heath, and a Regional Director of Quality for a multi-state home health and hospice chain.

Certified OASIS Specialist-Clinical (COS-C) credentialed. Certified Home Care Coding Specialist-Diagnosis (HCS-D) credentialed. Over 20 years multi-level home health experience, serving the full age spectrum from elderly to pediatric patients as a field nurse, case manager, as well as clinical director. AAPC Certified Professional Medical Auditor Graduate, 2014. Certified Care Transitions Coach obtained from the University of Colorado.

Speaker 2015 & 2014 Decision Health Webinars; topic: Face-to-Face New Requirements and Denial Prevention. Speaker 2013 National Home Health Coding Summit (Decision Health); topic: Coding Compliance. Speaker 2011 National Quality Outcomes and OASIS-C Conference (Hosted by Decision Health); topic: Home Health Face-to-Face Processes.

Frequent contributor to Home Care periodicals, Home Health Line, Diagnosis Coding Pro, and OASIS-C Outcome and Solutions, 2012-2015.

Expert in medical necessity chart review, survey protocols, and advanced trainer on home health and hospice benefit policies, OASIS, and ICD-9 coding. Dynamic transactional leader with proven ability to motivate and inspire others to deliver productive, cost-effective, and exemplary health care services.

Magna Cum Laude B.S.N. obtained from UT Health Science Center and active Sigma Theta Tau International Honor Society member. Empower U Leadership Awakening graduate.

PROFESSIONAL EXPERIENCE

Select Data, Anaheim, California 2014 to Present

Chief Clinical Officer

Clinical Thought Leader advancing coding and revenue cycle solutions to the Home Health and Hospice industry.

Designed a proprietary OASIS-C review technology solution that tracks/reports OASIS trends down to clinician level.

Designed a proprietary coding query category solution that tracks/reports coding query trends down to clinician level.

Developed custom content as well as analyzed/purchased vendor education content for new coder orientation/education solution delivered via Learning Management System (LMS) to coders located throughout the United States.

Developed coding competency program through advanced coding assessments and daily complex code surveillance program revision. OIG 95% acceptable coding error rate maintained throughout employment.

Doubled coder base through innovative design of a Coding Bridge program. This program transforms acute-care/outpatient coders into successfully cross-trained home health and hospice coders after intense education and multiple layers of competency verification. This talent acquisition/preparation program has resulted in securing the largest coding contract in the company’s history – 10,000 records per month.

CHRISTUS Continuing Care-HomeCare Division 2009 to 2014

Regional Director of Quality Management

• Key member of CHRISTUS Leadership team responsible for all aspects of clinical service quality for 16 home care and hospice offices located in Texas and Louisiana.

• Clinical quality leader with a proven track record of 50% of home health agencies achieving “Home Care Elite” status, an independent rating of home health quality and performance. The 2011 HomeCare Elite list, compiled annually by OCS HomeCare and DecisionHealth, names the top 25 percent of home health agencies in the United States.

• Successfully lead all home care and hospice offices through CHAP re-accreditation survey process with zero condition level deficiencies throughout all regions. The corporate office received a perfect survey with zero deficiencies cited in 2009 and 1 standard level tag in 2012.

• Instrumental in the on-going remediation of IT software systems. Serves as the chief nursing subject matter business expert for HomeCare and is actively involved in process redesign, education/support, and overall structure of point of care technology/SHP data mining solutions.

• Developed a comprehensive coding education program to maximize reimbursement and increased the number of certified home health coders from 2 to 7 within 9 months.

• Champion of two strategic initiatives: Improving OASIS inter-rater reliability and compliance audit processes. Position reports directly to Chief Nurse Executive.

Altegra Health 2012 to 2012

Palmetto GBA Medical Claims Auditor (Contractor)

Remote auditor performing Palmetto GBA Home Health and Hospice ADR on behalf of CMS

Restorative Healthcare, San Antonio, TX 2004 to 2009

Director of Nursing

Overall clinical operations for a Medicare-certified home health agency with a patient census of approximately 400+; Lead OBQI/OBQM initiatives for division; Supervising Nurse per licensure for all patients under license which exceeds 1,000+ for all branches.

Successfully implemented Life Link Telemonitoring Program and decreased acute hospitalization rates to below state and national percentages per CMS Home Health Compare.

Superior OASIS and ICD-9 coding skills; COS-C and HCS-D certified with increased HHRG/revenue for agency due to these expert skill sets.

Chosen by KCI Research for Wound Vac Clinical Trial Study Site

Clinical leader to over 55 licensed nurses

Also served as Pediatric Director of Nursing leading over 100 licensed nursing personnel

CHRISTUS Santa Rosa Children’s Hospital, San Antonio, TX 2003-2004

Pediatric Registered Nurse

Emergency medicine nursing position delivering care to Code II/Code III medical patients

Adjunct staff to the Respite Station serving the needs of medically fragile children and their families in an acute care environment.

Technical experience providing all types of IV therapy, nebulizer treatments, g-tube feedings, trach care, medication administration and wound care.

Home Nursing & Therapy Services, San Antonio, TX 2001-2003

Corporate Director of Nurses

Managed over twenty-five licensed nurses, with overall clinical responsibility for 750+ patients in the licensed home health division, plus full responsibility for all aspects of market growth to further the organization’s goals.

Reported directly to the Chief Executive Officer of the company.

Performed all types of skilled nursing/OASIS visits for Medicare Home Health division, various types of CBA/PHC assessments/supervisory visits, and MDCP supervisory visits.

Willows Development Center, San Antonio, TX 1999-2001

Director of Nurses

Responsible for overall clinical operations of a 104-bed ICF/MR skilled nursing facility, with supervision responsibility for over thirty licensed nurses.

Implemented clinical competencies for licensed nursing staff, developed executive nursing report targeting medication error reduction, and developed in-depth orientation program.

Brit-Tex Nursing Service, San Antonio, TX 1997-1999

RN Case Manager

CCP/MDCP program leader, with supervision responsibility for licensed nursing staff performing pediatric private duty nursing care.

Performed Medicare home health visits, IV infusion, and complex wound care visits.

EDUCATIONAL EXPERIENCE

University of Texas Health Sciences Center, San Antonio, TX 1996

Bachelor of Science in Nursing, MAGNA CUM LAUDE

Sigma Theta Tau International Honor Society of Nursing

University of the Incarnate Word, San Antonio, TX 1993-1995

Nursing Major

Endowed Scholarship recipient; Deans’ List 1993-1995

Brazosport College, Lake Jackson, TX 1990-1992

Nursing Major

Graduated top of Licensed Vocational Nursing Class 4.0 GPA

REFERENCES AVAILABLE UPON REQUEST

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