Peggy S. Hembree, RN, BS, CCM

Registered Nurse, Certified Case Manager, Clinical Liaison

903-***-**** adzxet@r.postjobfree.com 17801 Sunset Strip, Flint, Texas 75762

Qualification Profile

A results-driven, experienced Registered Nurse, (Certified) Case Manager with a 47 year history in various types of hospitals, hospice services, Assisted Living Facilities, home health and nurse phone triage, utilizing strategic planning, patient and family assessments, physician relationships, and knowledge of Medicare / replacement policies / managed care / worker's comp / Medicaid / Long-term care policy contracts to assist with patient disposition and best outcomes management.

Able to plan and multi-task for changes in daily activities. Responsible for management of plan of care and resources within length of stay guidelines. Skilled in handling patient and family questions, end of life discussions and decisions, insurance guidelines, and complaints. Able to communicate goals with team members to facilitate outcomes and monitor variances. Able to evaluate options, assist with decision making and services available, and report as appropriate. Leadership abilities and organizational skills regarding team initiatives and referrals to appropriate departments, consultants, and providers of care. Community awareness and abilities to seek out community programs for patient and family benefits and counseling services. Excellent oral and written communications skills. Able to discuss care with physicians, patients, family members, insurers, and next level of care sources.

Credentials

RN - licensed State of Texas, 1976 (Kilgore College)

BS - Business Management, 1993 (LeTourneau University)

Certification as Case Manager, 20+ years, (Commission for Case Manager Certification) effective thru 2018 and Certification as Rehabilitation Registered Nurse (expired)

Experience

Long nursing career with various types of experience including home health nursing and CBA supervision, dialysis (in-patient as well as out-patient), medical - surgical nursing, oncology, physical rehabilitation, and long-term acute care (LTACH) hospital patients, hospice services. Comfort with end-of-life discussion and evaluation, hospice experience as a clinical liaison, evaluating patients, then recommendation and implementation of services (home, nursing home, assisted living facility, in-patient hospice facility), DME, determination of diagnosis for EMR. Marketing component and relationship-building with referral sources and hospital case managers; event and function planning. Administrative experience over time in various settings: home health, dialysis, rehabilitation, skilled nursing unit in hospital, hospice, and LTAC hospital settings.

Various nursing leadership positions including Director of Patient Care in 36 bed LTAC hospital, Program Coordinator for inpatient physical rehabilitation hospital, opening home health office as Regional Director, charge nurse positions in various settings. Training as Alternate Director of Nursing / Alternate Administrator for a new home health office. Teaching Medication classes in assisted living facilities.

Exposure to risk-management systems and software (Risk Master). Experience in discussing loss claims with patients and/or family members, then forwarding to appropriate department for documentation and resolution. National Association of Long Term Hospital (NALTH) data collection and participant in a 2-year study of outcomes with ventilator patients, including followup data. Ongoing NALTH data collection on each patient weekly and upon discharge using NALTH data set. Coordination of various discharge needs for patients and family members: medical equipment, skilled nursing facilities, in-patient and out-patient hospice, rehabilitation, home health, out-patient and community services as available.

History of handling potential admission inquiries and referral calls with patients, staff, family members, insurance providers, physicians and physician extenders, and other sources regarding services available.

Contact and working with appropriate department for resolution or admission. Response to payer inquiries and needs to continue recertification of hospital days with appropriate documentation in hospital computer systems. Experience working within hospital settings, multiple departments, multiple managers and multiple physicians on case.

1974 - 1988 Work history

Orthopedic Surgeon in Kilgore, Texas, during nursing school, continued there as a graduate and RN. Began hospital nursing career in 1976, first at Medical Center Hospital (then became East Texas Medical Center), Tyler, Texas (Medical-Surgical unit), then Linden Municipal Hospital, Linden, Texas (small rural general hospital), and Good Shepherd Medical Center, Longview, Texas (hemodialysis), and University of Texas Health Science Center, Tyler, Texas (oncology).

East Texas Medical Center, Tyler, Texas

1988 - 1997 Rehabilitation unit / hospital

Started when CARF-certified unit was expanding to 20 beds, and moved to case management when new free-standing hospital expanded to 49 beds. Moved to Shreveport, La., as a contract manager for a hospital inpatient rehabilitation and skilled nursing unit. Rehabilitation unit was primarily orthopedics and expanded neurological services.

East Texas Medical Center, Tyler, Texas

1998 - 2010 East Texas Specialty Hospital, "hospital within a hospital" at ETMC, but owned separately. Eventually became part of the East Texas Medical Center system.

CASE MANAGER, DIRECTOR OF PATIENT SERVICES, CASE MANAGEMENT MANAGER

Long-term acute care hospital (LTACH) case manager, which at the time of employment included pre-admission assessments, marketing to increase referral source knowledge about the LTACH and appropriate patients, managing a waiting list and admission coordination. Interim then Program Director responsibilities. Responsible for all patient care services, disciplines (nursing, PT, OT, ST, RT, infection control, social work), and daily operations, reporting to Post-Acute Services Directors.

Hospital was acquired by ETMC (East Texas Medical Center), hospital expansion to include wound care program. Case management position evolved into full-time, one person department for 36 bed LTAC hospital.

Grace Visiting Nurses, Tyler and Jacksonville, Texas

February 2011 - June 2011 BRANCH OFFICE MANAGER

Company expansion to Tyler, new office opening for CBA (Community Based Alternative) client care, as well as skilled nursing options, with main office remaining in Jacksonville, Tx. Responsible for office business functions, supervision of nurses making CBA visits, coordination of providers and private pay home care aides.

Hospice of East Texas, Tyler, Texas

June 2011 - April 2016 CLINICAL / HOSPITAL LIAISON

RN visits to area hospitals (Tyler, Athens, Henderson, Jacksonville, Palestine, Quitman, Winnsboro), nursing facilities, long-term and rehabilitation hospitals, and assisted living facilities to assess eligibility for hospice services, then coordinate inpatient or home-based care, medical equipment needs, and physician acceptance for hospice program and orders. Communication-intensive position, working with physicians, patients, family

members, HOET facility liaisons, DME provider, nurses, social workers, discharge planners, and case managers. Some after-hours "on call" for hospital evaluations, and between-call marketing functions and expectations. Provide education for patients, family members, and hospital and other referral sources regarding hospice criteria and eligibility. Marketing responsibilities and participation in facility events, including visits to hospital discharge planners, case managers, and social workers.

Attendance at community events, personal attendance at Tyler Healthcare Industry Networking Group (T.H.I.N.G.) meetings, and former HDH Coordinator, bringing together Tyler area healthcare and marketing personnel at after-hours events.

Atria and Frontier Management Assisted Living Facilities - Resident Services Director June 2016 - February 2018

Patient assessments to determine appropriate placement in Memory Care, Assisted Living, Independent Living Facilities; assigning levels of care, communicating with residents / staff members, family members, responsible parties regarding acceptance and charges.

East Texas Medical Center Behavioral Health Hospital

Feb 2018 - August 2018 Staff Nurse, child, adolescent, and adult psychiatric and addiction dependence units. Facility bought by Ardent, then UT Health system, Behavioral Hospital closed.

Christus Mother Frances Hospital, Louis and Peaches Owen Heart Hospital, Pulmonary Unit

Sept 2018 - March 2019 Staff Nurse on new pulmonary unit, which became an ICU / Covid unit

March 2019 - present Christus Trinity Clinic After Hours Nurse PRN for several months, then full time overnight shift. Currently FT 8pm - 8 am.

Affiliations

Former member of Rehabilitation Nurses Association, formerly certified Rehabilitation RN (expired)

Commission for Case Manager Certification, CCM, valid thru 2018

References:

Janet Jordan, MSN, RN, Instructor, University of Texas Nursing School 903-***-****

Lisa Lewis, former Executive Director, Atria Senior Living 903-***-****

Rachel Fouse, FNP, Four Seasons Women’s Health, former After Hours RN 903-***-****

Christine Gish, RN, MSN, former After Hours Nurse Manager 815-***-****

Contact this candidate