Rhonda K. Johnson, RN, RAC-CT

West Des Moines, IA 50266

714-***-****

acxmae@r.postjobfree.com

Iowa Board of Nursing – Compact Registered Nurse – ANNAC Certified Resident Assessment Coordinator since 2006

Highly motivated, self-starter and qualified Registered Nurse with 20+ years of long-term skilled nursing experience in all areas of Long Term Care, moving from NOC Supervisor to Lead MDS to Corporate MDS Specialist. I have a passion for excellence for myself and for those team members I am fortunate to have oversight of. Strong core belief that the services provided to our frail elderly during their SNF stay are valuable and life-changing, clinical compliance leads to improved resident outcomes and allows for greater capture of services provided. Demonstrates result-orient problem solving, ability to implement strategies that drive clinical reimbursement with a focus on quality assurance, Quality Measures, 5 Star, Case Mix Indexing. With Success in:

Regulatory Compliance for OBRA, PPS and HMO A

No Default days in the previous 5 years by systems oversight

Medicare Part B Management for impact to Case Mix

ARD Management for OBRA and PPS to capture highest level of services provided

PPS Systems Compliance on Admission with CWF, PSAIF, Medicare Secondary Payer

Notice of Medicare A Non-coverage Letters, SNFABN to insure Valid Delivery

MD Certification Management to ensure Valid Delivery

Appeals Management

RAC Audit Management

Routine Auditing to ensure highest degree of MDS Accuracy with education f/u

Staff Training and Development in all areas, to include ADL Accuracy, Skilled Nursing Documentation, PHQ-9 and capture of depression indicators, RNA Program Compliance; all CMS Regulatory changes, ie: Section GG training implemented one month prior to October 1, 2016 for preparation with compliance

Works hand-in-hand with Regional therapy Manager to insure greatest level of reimbursement capture, accurate ARD’s and COT compliance.

Assist facilities with improvement in utilization and clinical systems with both on and off-site review

Development of all needed training tools, Power Points, Tip Sheets, RUGs booklet for referral to capture appropriate therapy and nursing RUGs

Work History

Lyon Financial, Lincolnwood, IL - 8-10-2015 to 11-14-2016

Regional Reimbursement Specialist

Remote and On Site Management of up to 12 facilities in MO, IL, TX, MI, KS and FL, CMS Regulatory compliance with MD Certifications, NOMNC Process, ADL Accuracy, MDS type, timing and sequencing accuracy, MDS information accuracy, compliance to completion and submission guidelines, ARD choices to maximize capture of the highest burden of care provided,

MDS training in all areas of MDS process, to include ADL’s, Skilled Nursing Documentation, PHQ-9, Respiratory Therapy, Denials, MD Certifications

Hands on MDS completion as needed.

On-site and off-site oversight of systems to insure accurate information and compliance to setting ARD’s, COT management, EOT, EOT-R, SOT.

Oversight to prevent default (NO default days during employment tenure)

Maximize RUGs to capture the true burden of care provided and oversight of Case Mix Indexing maximization for KS, MN, IL and TX.

MGM Healthcare St. Louis, MO - 4- 2015 to 8-2015

Regional Resident Assessment Coordinator

Oversight of six Iowa facilities for compliance to all CMS Regulations including MD Certifications, NOMNC Process, ADL Accuracy, type and timing MDS accuracy, MDS information accuracy, placement of ARD to maximize capture of the highest burden of care provided, MDS training in all areas of MDS process, hands on MDS completion as needed.

On and off-site oversight of systems to insure accurate information and compliance to setting ARD’s, COT management. Oversight to prevent default and maximize RUGs to capture services actually provided and oversight of Case Mix per Iowa Guidelines.

Reason for leaving: I was offered a job with Lyon as a result of a previous co-workers recommendation.

EmpRes/EHC/Evergreen Healthcare out of Vancouver, WA– 2002 to 2015

Lead MDS Coordinator May 2002 to June 2006, Fullerton, CA Facility

Promoted to Utilization Review Specialist – June 2006 to 1/31/2015

Promoted to corporate utilization oversight position from lead Resident Care Manager (RCM) at Evergreen Healthcare Center, Fullerton, CA, June 2006, initially all done from home office the first six years of he position by record review in HMX and Weekly call with each RCM and Therapy Manager

Accuracy/assurance control of MDS 3.0 for 20 EHC facilities for 250 Average Daily Census; manage Case Mix with increase in Case Mix from average 2.0 to 3.0; reduced MDS error rate requiring decrease in need for modification

MD Certification compliance per CMS regulations to prevent denial of payment

Valid Delivery of the Medicare A, Medicare Advantage NOMNC; SNFABN compliance; 60 day break in spell of illness; 3 day Qualifying Hospital Stay; and Presumption of Coverage

Development of teaching/training tools for Skilled Guidelines, RUG levels, Nursing Documentation to support Skilled Services, CMS changes, MDS completion guidelines, type and timing of MDS to combine OBRA and PPS, CAA’s understanding and completion, working Care Plans to enhance clinical outcomes

Therapy Regulations management to include COT management, Short Stay completion requirements, EOT, EOT-R’s, SOT’s

Nursing Guidelines for Skilled Services with Supporting Daily Documentation for RUG level, MDS Scheduling.

New Employee orientation, to include training of 4 MDS Nurses without prior MDS experience for lead MDS position, with no default days at Tacoma, WA, Idaho Falls, ID, North Seattle, WA or Bellingham, WA facilities.

Communicate with facility field staff, Regional Team, Corporate Office regarding compliance to systems or compliance issues and work with them to resolve those issues at the facility level

1:1 communication with BOM, MDS, ED, SS, DNS, Therapy Manager, Regional Vice President, Nurse Consultants, Regional Therapy Director

Training and management of ADL accuracy – Develop Training Modules for 1:1 Training with individuals or teams to improve the capture of accurate ADL function for self-performance and ADL support of skilled service

Provide ARD management with facility teams to assist them in utilizing the ARD that captures the highest burden of care, compliance to MDS scheduling regulations

Chart reviews on and off-site routinely for MDS completion, MDS Accuracy and capture of provided skilled services.

RAC audits; Participation in the response to RAC audits with chart review and composition of letters for review and redetermination.

All components of PPS Management to maximize reimbursement, avoid default days in California, Washington and Idaho facilities and improve Case Mix management in the Washington and Idaho facilities.

Reason for leaving: Company required a move to state of Washington

Lead RCM at Evergreen Healthcare of Fullerton – May 2002 to June 2006

All MDS duties to include daily PPS Meeting, Management of compliance and outcomes with Tracking of MDS windows, ARD’s, ADL’s, MDS completion requirements, transmission, accuracy, Validation, managing the OBRA and PPS schedule for the IDT, Case Mix management, MDS, RAP’s (Now CAA’s), Care Plans

Sent to company’s other facilities for teaching and training new MDS, conducted audits of Medicaid audits for Root Cause Analysis

Worked as the Supervisor, Treatment Nurse or Charge Nurse all three shifts, weekends and holidays with hands on patient care

Promoted to EmpRes Corporate MDS Utilization Specialist with oversight of 20 facilities

Sunny Hills Convalescent Hospital – Sunny Hills, CA – October 2000 to April 2002

Lead RCM responsible for all MDS duties including PPS management, OBRA, proofreading, inputting, transmission and validation of all MDS, care planning, staff training for MDS compliance, MD certification management

Bel Tooren Villa Convalescent SNF, Bellflower, CA – October 1998 to October 2000

Lead RCM promoted to Director of Nursing 6 months after hire

Hands on nursing care with extra shifts during job as MDS

Huntington Beach Convalescent, Huntington Beach, CA – September 1997 to October 1998

NOC Supervisor responsible for care oversight, diabetes management, insulin injections, IV medications, G-tube feedings, all discharges to the acute and prevention of, as able

Promoted to MDS

West Anaheim Extended Care, Anaheim, CA 1994 to August 1997

NOC Supervisor responsible for care oversight, IV medications, diabetes management with insulin injections, all discharges to the acute and prevention of

Iowa Lakes Community College, Emmetsburg, IA - August 1990 to May 1993 – Associate Degree Nursing – Deans List – Cum Laude

American Association of Nurse Assessment Coordination- Resident Assessment Coordinator Certified (RAC-CT) for MDS 3.0 2006

References Available On Request

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