Ioni McIlrath

Summary: AHMC HealthCare, a for profit corporation, purchased 4 Star Seton, and Seton Coastside out of bankruptcy, from Verity Health System, a non-profit, in August 2020 with a total of 357 beds. Originally established in 1893, was the birthplace of progressive Cardiovascular Programs such as Balloon Angioplasty and Transmyocardial Revascularization, and still today provides a comprehensive complement of services. Included are three Post-Acute units, 39 bed short term, 116 bed long term SNF and 44 bed Sub-Acute. Acute Hospital responsibilities include departmental oversight of Utilization Review, Denials Management, Case Management, Social Services, Palliative Care. Additional departmental support for Revenue Cycle, Quality, HIM, Admitting, Pharmacy and Wound Care. Focused on Lean philosophy of delivering value, reduction of waste and improving processes, along with repairing labor management. Post-Acute responsibility for all Operations of three facilities, including monthly P&L, budget, expense, regulatory, reporting, licensing, policies and procedures, patient quality, safety and satisfaction. Additionally perform job functions below as Director of Clinical Resource Management under Verity Health System

• Accomplishments:
• Successfully passed 7 Hospital Surveys and 3 Post-Acute Surveys, including TJC, CDPH, OBRA, CHOW, OSHPD, COVID -19 Mitigation
• Collaborate with corporate and administration to identify and cut loss leaders while supporting all departments to lower monthly losses of $8M to $3M in first year
• Recruit graduating CNA and LVN students from Northern California University for all areas
• Lead committee for: Utilization Review, QAPI, Revenue Cycle, Denial Management, Complex Case Management
• Committee member of: Quality, Pharmacy, EOC Rounds, Anthem Blue Cross, HPSM
• Involved in: Daily Productivity, IDT Rounds, Mortality and Readmissions, Ethics, COVID-19 Acute and Post-Acute, EVS, Facilities
• Revamped matrices for all Post-Acute units to industry standards and negotiations with NUHW
• Increased Post-Acute Star rating from 1 to 3 in 7 months, anticipating to be at 4 by June 2022
• COVID-19
• Mitigated COVID outbreak at Seton Coastside and operationalized weekly and bi-weekly testing
• Oversee COVID-19 Visitation, COVID and Flu Vaccination Clinics

Summary: Same data as above. While in bankruptcy, worked with physicians and staff to give high quality care to patients and lower length of stay. Director of Case Management, Social Services and Palliative Care for Acute Hospital and affiliated Distinct Partner Skilled Nursing Facilities and Sub-Acute.

• COVID-19: Bay Area Surge Hospital for 5 Bay Area Counties. Successfully operationalized 120 beds for State of California. Surge hospital for San Quentin State Prison and executed throughput with correctional administrative team. Created and executed direct COVID-19 admission policy and process, flowchart, HUB and direct responsibility for staff
• Work with Hospitalists, Community Physicians and Specialists to align hospital best practices and expectation to earn Leapfrog A and lower LOS
• Created: Specificity Chart for MD documentation to capture highest DRG and CMI, Bedside Checklist for increased communication of IDT and family, RN WOW guide for workflow, Post-Acute Preferred Provider Network for SNF, Home Health, IRF, LTACH, SAU and Hospice, SNF weekly reports of all “Return to Acute”, new IDT process with support of ongoing improvement
• Decreased Length of Stay of Geometric Mean LOS (GMLOS) index of 1.6 to 0.06 with a complex patient population requiring social and palliative care needs with average CMI 1.9
• Increased Palliative case consults by 300% through development of strong program and team, close management with hospitalist leadership and community physician education
• Supported decrease in Hospital Acquired Conditions and Falls by 50+% and decreasing cost per case by 20%
• Implemented new Resource Management Steering Committee that introduced initiatives to improve results under Medicare's Bundled Care Payment Initiative
• Decreased readmissions and improved discharges to Home with Home Health, with implementation of tele-health monitoring, supporting reduced use of Skilled Nursing Facilities
• Redesigned daily discharge huddle process incorporating CMO, PA, CNO, CFO and nurse managers focusing on barrier management and decreased avoidable days by 25%
• Introduced Bedside Discharge Checklist and associated processes with nursing leadership, increasing early DCby 40% with orders before 10:00 a.m and discharges before 12:00 p.m
• Developed Complex Case Management process to include all key team members decreasing long LOS patients by 80%
• Focus on complex discharges of patients greater than GMLOS and LOS over 30 days with limited discharge options
• Analyze data for mortality and readmissions, LACE scores, UM, homeless visits/admissions, denial management, quality measures and CMI
• Combine strategic and empirical management skills to meet and exceed budget goals and enhance revenue
• Create strong teamwork and supportive environment within Case Management and hospitalists, community physicians and specialists
• Collaborate with CHA, San Mateo Co. and LCSW on SB1152 P&P
• Creation of HealthStream modules for staff education

Kindred Hospital SFBA is a 99 bed Long Term Acute Care Hospital, working with complex patients needing specialized advanced care and therapy an acute hospitalization

• Responsible for principles, policies, procedures and goals for Case Management Department
• Train, develop and motivate staff to accomplish department goals and objectives while focused on safe, ethical quality care
• Develop and oversee annual budget
• Prepare and evaluate monthly, quarterly and annual reports
• Comply with Medicare regulations and provide current guidelines to leadership, physicians and others
• Maintain prospective payment system, monthly case log and files needed for peer review and specific needs of the hospital
• Analyze physician utilization patterns, comparing data with national and hospital standards to present findings in Utilization Review committee meetings
• Denial management and review of coverage related to Utilization with Director of Quality
• Analyze avoidable delay data in conjunction with review of primary payor organizations and secondary payors
• Weekly review of all data and quality measures with executive team
• Build and maintain working relationships with community partners
• Conduct GHO and train new hires
• Work with executive team on RTA, ethics, complex and long length of stay, restraints, and infection control while always striving for excellence
• Accomplishments:
• Recognized for Excellence for Kindred LTACH of 85 hospitals. Created presentation “No One Left Behind” for annual DCM conference in Louisville, KY, Regarding philosophy and mentorship of Case Management and Social Service Teams
• Collaborated with CDPH, Alameda County Public Health Department (ACPHD) and infectious disease consultant to develop strategies and best practice for patients with MDRO and CRE
• Planned and hosted educational community events regarding MDRO-CRE best practices with CDPH and ACPHD for community SNF and SAU partners
• Successful TJC surveys and CMS validation surveys
• Ranked #2 for Kindred LTACH past 2 years as DCM, exceeding budget and expectation
• Decreased ALOS by 14 days for surgery patients, med-surg/tele by 4 days, increased normal low MCR discharges to meet budget
• No Case Management employee turnover
• Continued monthly staff audits ranging from 95-100%
• Mentor Samuel Merritt University Masters students for final clinical rotation before graduation
• Excel in collaboration with ICP, IDT, specialists, consultants, and executive team
• Increase patient and family satisfaction scores
• Provide specialized complex case management for patients with high level of comorbid conditions.

High-end clientele to evaluate personal financial portfolio regarding second home financing and unique real estate investment planning of $500,000-$5,000,000 properties

• Stayed onsite for each launch of new properties and facilitated in sales and lending of homes
• Conducted purchase and refinance lending in the San Francisco Bay Area
• Stayed current on all new products available and hosted networking events with other brokers.

Big Burrito Co, Honolulu HI, 7 Stores

• Created concept and design, raised capital, oversite of build out of central commissary and 7 retail stores on Oahu
• Sales, marketing, quality control, distribution, inventory, staffing, payroll and training for all locations
• Applied performance data to evaluate and improve operations, target current business conditions, and forecast needs
• Optimized team hiring, training and performance
• Hosted large island events

Treat’s Sidewalk Café and Bakery, Bay Area 3 Stores

• Managed all operations and functions from quality control, book keeping, payroll, staffing, training, inventory, purchasing, food preparation, production and sales.
• Remained up-to-date on current trends and attended industry trade shows and markets to view and order inventory
• Reconciled daily sales, returns and financial reports in QuickBooks