Colleen Moon

• Transitioned from final stages of construction to opening and operating the newest State Veterans Home in Post Falls, Idaho
• Evaluated needs of departments to set up systems and processes for operational effectiveness.
• Applied for facility enrollment to in Medicare and Medicaid.
• Applied for National Provider Identification (NPI)
• Implemented administrative policies, procedures and guidelines to facilitate new operations.
• Coordinated with State and VA Survey Agencies to ensure compliance for new facility.
• Collaborated with Fiscal and HR team to determine organizational needs and position requirements for potential employee candidates.
• Hired all department managers.
• Reviewed all admission applications and medical documentation for level of care needs.
• Conducted daily meetings with department heads to discuss census information, admissions and discharges for residents.

• Operated skilled nursing facility specializing in geriatric care for individuals with behavioral or psychiatric illness.

• Evaluate work performance of department heads and maintain accountability across all departments for expected performance outcomes.

• Maintained confidentiality of protected health information, including verbal, written, and electronic communications.

• Reported and investigated allegations of abuse, neglect, misappropriation of property, exploitation, or mistreatment of residents to appropriate regulatory entities.

• Ensured staff were properly trained on how to identify and protect residents from abuse.

• Lead facility Quality Assurance and Performance Improvement committee meetings to identify high risk, high volume, or problem prone areas that can lead to poor resident outcomes.

• Worked with Medical Director and Physical Therapy to improve the restorative nursing program.

• Collaborated with the Director of Nursing and Resident Care Manager to improve MDS assessment accuracy.

• Focused on improving resident ADL and mobility outcomes.

• Coordinated with local Fire Department to facilitate Fire Safety Plan.

• Extensive knowledge and understanding of Federal, State, and VA regulations related to long-term care.

• Stayed up to date with current regulations utilizing the Center for Medicare and Medicaid

(CMS) website, Idaho Department of Health and Welfare website, State Operations Manual

Appendix PP, NFPA 101 and NFPA 99 publications and Appendix Z of the State Operations Manual.

• Ensured compliance with regulatory changes and best practices of the long-term care industry by attending annual Idaho Healthcare, American Healthcare, and the National Association of State Veterans Homes (NASVH) Conferences.

• Collaborated closely with Administrators and the multidisciplinary teams in all three Veterans Homes implementing systems and processes to ensure high-level quality of care for the residents while maintaining regulatory compliance.

• Used CMS's Critical Element Pathway and the Electronic Medical Record (EMR) to audit incidents and accidents, alert charting, psychotropic medication, gradual dose reductions (GDR), behavior monitors, newly added antibiotic orders, nursing progress notes, and diabetic management.

• Analyzed resident assessment data to measure the quality of resident care and identify problems, patterns, or high-risk activities that could result in negative outcomes for the resident.

• Reviewed the Infection Control Program.

• Fluent in CFR (Code of Federal Regulations), IDAPA (Idaho Administrative Code), and Veteran Administration rules for nursing homes.

• Assisted with writing a non-compliance plan of corrections (POC) to submit to state survey agency.

Created and Maintained the Continuity of Operations (COOP) for all agency Bureaus.

• Provided leadership and direction for a seventy-seven bed Skilled Nursing and Rehab Facility with a staff of approximately 110 employees
• Ensured quality resident care in accordance with all laws, regulations, and LCCA standards
• Managed the operational budget, census, admission referrals
• Tracked resident rehab usage during benefit period ensuring resident goals were met
• Identified potential problems that can result in negative outcomes for the resident
• Directed staff through subordinate supervisors
• Lead the survey process
• Implement programs to increase resident supervision and decrease falls by two-thirds
• Doubled operating margin during second year and improved quality of care reaching five-star status on CMS Care Compare.