Michelle Riches MSN, APRN, NP-C Mogul Health PLLC

University of Nevada, Reno

Master of Science in Nursing, Family Nurse Practitioner Tract (06/2017) Orvis School of Nursing

Sigma Theta Tau Nu Iota Chapter; The Honor Society of Phi Kappa Phi, The Delta Epsilon Iota Academic Honor Society

Thesis: Exploring the Possible Reduction of Obesity Stigmatization in Healthcare and Womens’ Healthcare Avoidance

Bachelor of Science in Nursing, (12/2008) With Distinction

The Honor Society of Phi Kappa Phi, The Delta Epsilon Iota Academic Honor Society

Professional Memberships: American Academy of Family Physicians, Nevada Academy of Family Physicians, American Association of Nurse Practitioners, Nevada Advanced Practice Nurses Association.

Nurse Practitioner Experience:

ARC Health & Wellness 04/2020-Present

- Full-Time Employment in Occupational Health as Nurse Practitioner and Clinical Director/ Office Manager. My duties include performing: Commercial and Professional Driver Physicals, Workman’s Compensation as well as new employment evaluations. Heart and Lung Physicals for Fire-fighters and Law-Enforcement by collaborating with the patient lab results, diagnostics and performing cardiac stress tests. Bedside Carotid and Thyroid Ultrasounds. Familiarity with DOT, OSHA, FIT, Cardiac Stress Testing, VO2 testing. In addition to physical assessments and SOAP notes as a Nurse Practitioner, my duties include to perform office management as the Clinical Director. This includes supervising and performing employee evaluations, constructive criticism, training development and follow up with employees as necessary.

-Nominated by staff Northern Nevada Nurses of Achievement Award 2021.

Rapid Recovery Hydration Solutions LLC 06/2019-03/2020

- Part- time Contracted Employment for vitamin injectable and infusion services located in Reno, NV. The nurse practitioner provides evaluation and assessment of individual patient needs based off symptoms and chronic conditions. I provide education for clients in understanding of acute or chronic vitamin deficiency, dehydration, stressors and vitamin needs. I utilize experience from primary care and emergency medicine to start IVs and evaluate treatment plans for each client on arrival.

Transtreme LLC / West Coast Wellness LLC 03/2019- 03/2020

-- Full-Time Contracted Employment: Completion of Medicare Annual Health Assessments on a geriatric population in the home and embedded primary care offices. The annual wellness visit includes a health risk adjustment and personalized prevention plan services. The examinations include a thorough history and physical examination with emphasis in preventative screenings, family and social history. Perform multiple preventative in home/ office diagnostics including A1C, Flow Obstruction/ ABI, Peripheral Neuropathy/ DPN, Retina Scanner, and Bone Density.

-Understanding and training in the hierarchal condition category coding (HCC) and HEDIS (Healthcare Effectiveness Data and Information Set) as well as 5-Star quality documentation guidelines.

Veterans Health Administration: Primary Care/Ambulatory Care Provider 08/2017- 04/2019

-- Primary Care Provider managing a full provider panel in the Reno Veterans Administration. I was responsible for improved patient numbers and lab values for diabetes, hyperlipidemia, hypertension and opiate reduction. I made a positive impact in the assigned Reno Panel diabetic veterans in reducing A1C’s greater than 9 from 17.6% to 12.3%.

I collaborated on the pharmacy and therapeutics committee to ensure new antibiotic guidelines for acute illnesses, including urinary tract infections, upper respiratory infection, Pneumonia and those significant comorbidities in the antibiotic order menu. Primary reference of the Washoe County bio gram. Participation in pharmacy and therapeutics committee changes in Stroke Management Protocol, Acute Coronary Syndrome Protocol, Diabetics and IV contrast on Metformin Protocol and many others.

I utilized the primary care team regarding opiate prescribing practices to increasing informed consent, urine drug screens, patient compliance, and reduction of inappropriate opiate prescribing practices. The combined panels had increased in percentage of urine drug screens from 25% to 100% compliance.

-- My tour of duty was formally changed to Fallon, Nevada CBOC clinic. Utilization of VTel practices to increase provider access through a computer interactive appointment two days a week. I continued to make great strides in the management of veterans’ diabetes, hyperlipidemia, hypertension and opiate reduction.

I positively decreased the Fallon panel veterans with an A1C of greater than 9 from 32% to 14%. The percentage of veterans whose blood pressure was less that 140/90 in my Fallon panel was 4.4% positively increased to 10.2%. The percentage of veterans in my Fallon panel whose BP was less than 130/90 was positively increased from 26.7% to 35.5%. Then achieved management required goals of reducing morphine equivalents from 48,000 to 12,000. I as well reduced the prescriptions of greater than 90 morphine equivalents daily, for chronic non-cancerous or non-palliative pain, from 9 veterans to 0 veterans.

- Nominated Northern Nevada Nurse of Achievement Award 2019

Previous Nursing Experience: (2004- Present)

Saint Mary's Hospital: Registered Nurse - Emergency Department 10/2014- Present

-- Currently per-diem with previous full time employment in Saint Mary’s Emergency Department from the non-emergent to the critically ill. Using the nursing process to care for patients of all needs from newborn to geriatric.

Northern Nevada Medical Center: Registered Nurse 10/2012-10/2014

-- Full-time employment primarily Recovery Room. Floating frequently to Pain Center, Pre-Admissions Testing, Pre-Operative, and Emergency Department. Assisted frequently with endoscopy.

-- Super User and Instructor for CPOE and new computerized charting program for all employee’s. Charge nurse and management roles as needed by department, including staff scheduling, training and orientation of new employee’s.

-- Instrumental in Joint Commission accreditation for Low Back Pain (Pain Management) and team member for Joint and Spine Certifications through ensuring proper documentation and chart editing.

--Nominated Northern Nevada Nurse of Achievement Award 2014

Carson-Tahoe Regional Medical Center (2004-2013)

Registered Nurse- Emergency Department 01/2009 to 7/2013

-- Full-time employment handling multiple patients from the non-emergent to the critically ill. Using the nursing process to care for patients of all needs from newborn to geriatric.

-- Super User and instructed physicians, nurses and staff for CPOE and new computerized charting program for all employee’s. Charge nurse role as needed to keep flow of emergency department.

-- Nominated Northern Nevada Nurse of Achievement Award 2010

Certified Nurse Assistant & Emergency Department Technician 02/2004 to 1/2009

Medical/ Oncology Unit- assisted nurses and providers with procedures, bathing, assessment of vital signs and a multitude of delegated tasks within the nursing assistant scope of practice. Frequently floating to other units within the hospital as needed by management. Worked fulltime while pursuing a bachelor’s degree in nursing.

Emergency Department - assisting nurses and providers with procedures, wound care, ambulation, and many other tasks as needed by nurses. Provided bedside nursing services as instructed and required by the registered nurses and providers. Worked fulltime while pursuing a bachelor’s degree in nursing.

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