Janice Fenske, R.N. BSN,CCM, CLNC

***** ****** ***** **.

Valley Center, Ks. 67147

Phone 316-***-****

Education:

*2000 Medical Legal Consulting Houston, Texas CLNC Certification Program

*1999-2000 Southwestern College, Winfield, Ks. BSN

*1974-1976 Stormont-Vail School of Nursing, Topeka, Ks. Diploma of Nursing

*1973-1974 Washburn University Topeka, Ks. Prerequisite Courses For Nursing

Current Licenses and Certifications

*Certified Legal Nurse Consultant

*Registered Nurse State of Kansas

*FIM certification (March 2011-2014)

*BCLS

*National Health Safety Network

Work Experience:

November 2012-Current:

Manager of Casemanagement United HealthCare- Community and State Kansas- Have been manager of team from the initiation Community and State for KanCare January 1, 2013. Leading and directing team of 12 field based casemanagers at time of “go live”. Manager for Technology Assisted, Frail Elderly, Traumatic Brain Injury, Physically Disabled and Individuals with Developmental Disabilities waivers Four of those positions have transitioned to Telephonic Staff- who manage the IDD and PD wait list populations. .

Telephonic CC’s also manage Pre- Lockin Education Members, and Hospital To Home program.

*In this role, I am also a member of the Interdisciplinary Team reviewing high utilization members to develop strategies to reduce any over utilization identified.

Also Liaison to Stormont Vail Hospital Topeka facilitating integration of waiver programs with discharge planning process, and ER overutilization processes.

Serve on Casemanagement Policy Review Committee.

Serve on Service Review Team (utilization process for approvals/denials of waiver covered services according to company and State guidelines)

Serve on Community Transitions Team to identify Nursing Facility Members who may be appropriately served in a less restrictive environment.

Serve on review team for Minor Home Modifications/Assistive Technologies/Assistive Services.

October 2011-November 2012:

Chief Nursing Officer and Quality/Risk Director –in addition to the tasks below, supervising staff of 75 nurses/ rehabilitation techs– pharmacist, respiratory care and dieticians for 60 bed acute rehabilitation hospital. Have facilitated projects to improve documentation to meet PPS requirements, Initiated initiatives to improve patient satisfaction from 80's to current 95.2 overall. Significantly reduced overtime and weekend absences. Working with teams to improve communication between disciplines/shifts/patient’s and families.

Current Mutidisciplinary Process Improvement teams

* admissions process

* patient education with use of teach back techniques,

*discharge process flow improvement

* Patient Safety

* Hip Joint Replacement Team

* Stroke Team

Successfully prepared for The Joint Commission speciality certification Surveys for Hip replacement, and for recertification for Stroke Certification (July 2012).

Leading nursing and therapy teams to successfully convert current manual scheduling system to corporate computerized self scheduling system.

Currently facilitating iniative to prepare 14 nurses on staff for national certification as Certified Rehabilitation RN’s by December 2012.

Initiatives underway to improve clinical ladders and educational opportunities for nurses aides to become rehabilitation techs.

Assisting Infection Control Nurse as co facilitator for CAUTI (Catheter Associated Urinary Tract Infection )process improvement and data input (for rehabilitation hospitall’s first national required data reporting October 2012).

Coaching clinical and physician staff to improve compliant documentation.

Conducting chart audits and preperation for regulatory/payment audits.–Including audits and drafting reconsideration letters to Administrative Law Judge hearings.

Preparing and submitting timely, reports of risk management and quality to corporate and external agencies. Facilitated facility conversion to using new multi indicator quality grid reporting and use as template for monthly quality meetings.

Serving on Senior Executive Council, Medical Staff Quality Council and Governing Body. Working daily with DTO, CEO, Nurse Leader, and Therapy Leads to improve patient care processes

*March 2011-October 2011: Wesley Rehabilitation Hospital: Quality/Risk Director and Perspective Payment System Coordinator.Directing and planning all aspects of Quality and Risk Management. Ensuring proper compliance with regulatory agencies and The Joint Commission Accreditation. Responsible for helping to create an environment and culture motivating staff to improve performance and documentation to fulfill a mission to exceed national patient outcomes and satisfaction benchmarks. Facilitated full accreditation survey April 2011. Submitted corrective action plans and overseeing of action plans.

Facilitating/serving on PI teams for falls, multi disciplinary communication improvement, patient satisfaction, and Primary Stroke Rehabilitation. Preparing for upcoming recertification of our Stroke Program. Co-chairing teams preparing for Hip Replacement Center Certification. Serving on Infection Control Committee.

Completing Environmental Care Rounds monthly.

Also communicate and collaborate with all hospital departments and medical staff to coordinate care and promptly resolve concerns or complaints and response to the grievance per state/federal regulations and HealthSouth Corporate Policy.

Completing Risk Management roles as mentioned previously, collection and analysis of all error reports. Completing Root Cause Analysis as required and utilizing for process improvement opportunities.

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PPS Coordinator Role: Certified by UDS and responsible for compliance with regulations for completion of IRF-PAI admission and discharge FIM scoring. Identified concerns with inadequate supporting documentation impacting LOS, and CMI and initiating action plans for improvement making significant improvements. Working with nursing staff and therapy staff daily to understand their hurdles to completing the FIM scoring and documentation. –and developing processes to assist them in the quest. Participating in weekly regional teleconferences to collaborate on improvements in processes and documentation.

*September 2001- March 2011: Via Christi Regional Medical Center, Wichita, Kansas Continuous Process Improvement Coordinator/ Risk Management in the Quality and Patient Safety Department of an 850 bed acute care/ trauma center.

Reviewing Errors and conducting Root Cause Analysis for Sentinel Events. Also identifying processes that are potential safety concerns or areas for improvements and leading multi disciplinary teams to improve processes.

Remaining current on best practice data and making recommendations to change practices to remain current with standards to obtain best outcomes for our patients.

Identifying apparent deviations from standard medical practices, and referring cases for physician peer review.

Available to all staff in advisory role to assist when potential legal issues or family complaints occur.

*Involved with conflict resolution regarding patient complaint concerns.

*Providing case reviews and recommendations to Via Christi Legal Department (self insured) regarding potential or filed legal claims. And maintaining quarterly updates for potential claims.

Also working as liasion between legal and patients who have had harm due to medical error– negotiating to provide resolution prior to filing of legal claim.

*Serving on Pharmacy and Theurapetics Committee, Medication Safety Committee, Sedation Committee, Nursing/Pharmacy Committee, Clinical Coordinating Committee (responsible for continuous preparedness for JCAHO survey), Metrics Committee/Staffing Effectiveness and Nursing Standards Council, Fall and restraint committee, Nursing and Allied Staff Peer Review Chairman. Reviewing cases to determine reportable errors.

Involved in coordinating KDHE survey processes and JCAHO surveys.

*June 2000-Sept 2001: CorVel, legal nurse consultant, casemanager, and rehabilitation manager. Working as medical consultant to attorneys regarding healthcare/nursing issues on legal cases. Facilitating peer reviews, and coordinating Independent Medical Evaluations with providers. Working with providers in central/northern Kansas, facilitating patient care. As the Wichita branch manager provided leadership/mentoring for 10 casemanagers within the Wichita office.

*July 1999-June 2000: Hillsboro Community Medical Center, Hillsboro, Ks. Director of Nursing Services for Acute Care and Long Term Care Units.

*Responsible for recruitment and hiring staff.

*Supervise 75 employees in nursing departments.

*Management of workmen’s compensation claims for my departments, and representing facility in court hearings, regarding claims.

*Responsible for budgeting Long Term Care Unit, Surgery, ER, OB, and Acute Care Nursing Departments.

*Responsible for hospital pharmacy ordering, stocking and inventory.

*Policy and procedure revisions to insure compliance with current standards of care for all nursing areas of this facility, including surgery, emergency room, outpatient surgery, obstetrical and long term care.

*Working closely with CFO and CEO of this facility.

*Accomplished fully staffing the long term care unit which had been utilizing a considerable amount of temporary staffing.

*Coordinator for health care improvement pneumonia project with Kansas Foundation for Medical Care.

*Prepared grant proposal to initiate new program establishing cooperative effort between industry and health care to improve health status of community.

*Serving on Quality Assurance, Risk Management, Infection Control and Safety Committees.

*September 1998-July 1999: Corvel Inc. Medical Rehabilitation Consultant/Casemanager.

*Providing medical casemanagement/consultation services for approximately 40 insurance companies regarding medical care issues.

*Providing assessments of the patient (medical, psychological, social, environmental, and vocational..)

*Coordinated care with physicians, and other health care providers through out Kansas.

*Implemented conflict resolution strategies between employers, injured workers and insurance carrier (frequently collaborating with legal council.)

*Negotiating managed care contract fees.

*Working independently from home office as well as office in Wichita, Ks.

*January 1998-September 1998: Prairie View, Newton, Ks. Utilization Review/Treatment Plan Coordinator.

*Functioned as part of the mental health team for child/adolescent and adult teams.

*As team member, formulated treatment goals and treatment plans.

*Evaluated continuing medical necessity, and compliance with managed care utilization guidelines.

*Contacted managed care companies/insurance companies daily for concurrent reviews.

*July 1995-January 1998: Concentra Managed Care, Leawood Ks. Casemanager.

*Evaluated current medical treatments and medical status of ill/injured workmen’s compensation clients and catostrophic medical cases.

*Made recommendations to insurance company/clients regarding care providers and current standards of care to achieve highest rehabilitation goals possible.

*Completed job analysis for injured workers position at time of accident.

*Negotiated light duty work positions with employers to enable early return to work status for injured worker.

*Worked between injured worker and all involved parties (attorneys, insurance companies, client, employer, physician, therapists, etc) to coordinate medical care.

*Attending physician’s appointments with injured worker to discuss medical treatment plans with physicians and health care providers.

1990-1995 Herington Municipal Hospital, Herington Ks. Director of Nursing Services.

*Top nursing leader of twenty bed acute care hospital plus eighteen bed skilled nursing unit.

*Responsible for supervision of 50 staff members and budget of department.

*Revised nursing department policies and procedure manual to bring up to current nursing standards.

*Introduced strategies alleviating professional nursing shortage.

*Chair of Infection Control Committee.

*Established Blood borne Pathogen standard program for facility and served as educator for employee and community programs.

*Assisted local school system with establishing Blood Borne Pathogen standards, and provided education for entire school district staff.

*Liasion between nursing staff and physician’s staff.

*Initiated Advanced Directives Program, providing patient and community education programs.

*CARE program assessor.

*Served on Risk Management Committee.

*Served as liasion to Herinton Municipal Hospital Auxillary.

*Maintained surgical credentials assisting with surgical procedures, and diagnostic examinations and Emergency Room Coverage.

*Assisted in organization of Herington Branch of Hospice of Dickinson county.

1982-1990 Herington Municipal Hospital– Contracted to Memorial Hospital of Abilene, Ks. As Home Health Director.

*Established Home Health Care Branch Office and continued to supervise five employees.

*Introduced Home Health Concepts in area and built program to over three hundred visits per month.

*Patient assessments of the elderly, determining eligibility of clients, developing care plans, home visits, documentation/billing, casemanagement utilizing community resources, and requiring considerable dialogue with physicians.

*Iniated groundwork for establishment of hospice program.

*Recognized need for public awareness regarding health–and established local Health Fairs and continued to coordinate the local event thru 1995.

*Contracted to Dickinson County Health department to assist with well baby immunization clinics and county health functions, including HCBS screenings, and abuse/neglect investigations.

1980-1981- Lutheran Home, Herington, Ks. Long Term care facility.

*Responsible for supervision of care of 100 bed long term residents, and for monthly recertification documentation. Team leader of care team.

1976-1979 Herington Municipal Hospital, Herington, Ks. Staff nurse/Charge nurse.

*Responsible for all nursing areas provided at a rural acute care hospital. (Obstetrics, medical/surgical, emergency and pediatric patients.)

Honors:

Listed in Who’s Who American Nurses 1992.

Nominated for Kansas University’s 1992 “Nursing: The Heart of Health Care” award.

Nominated for Via Christi’s Sr. Catherine Sienna Award both 2007 and 2008 for human dignity award.

Professional Organizations:

Kansas Organization of Nurse Executives 1990-1995 and 1999-current- serving on legislative committee, advocacy and program committees.

KQRM (Kansas Quality & Risk Management Group)

And ASHRM (American Society for hospital Risk Managers)

Personal:

Married to John Fenske 1976-Current

Co-owners of K&F Distributors, and Carwash Technologies.

Mother of 4 grown children, and 6 grandchildren

References available on request.

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