Erin Minalda RN

-Develops discharge plan that addresses the psychosocial needs to meet desired goals for the next step in the continuum of care for the patients.

-Collaborates with the patient, family or other caregiver , and multidisciplinary team to design a discharge plan respective of the patients needs and goals.

-Facilitates communication among all treatment team members

-Manages length of stay by proactively identifying issues and barriers to care and a successful discharge plan

-Updated the care team, patient/family, as to the status of the discharge plans. Re-evaluates and revises the discharge plan as additional information is acquired.

-Proactively considers options such as palliative care, homecare, and other services that work to keep the patient as healthily as possible in the outpatient setting to minimize the risk of readmission.

-Issues applicable state/federal regulatory notices as applicable such as Important message from medicare(IMM)

-Identifies patients with a unplanned readmission and discuss with interdisciplinary team to analyze reason for readmission.

-Coordinates utilization of patient and community resources to facilitate achievement of safe and effective discharge plan

-Makes referrals to outpatient case managers to identify patients that would benefit from post discharge follow up

-Facilitates resolution of issues surrounding patient care in a compassionate manner, utilizing team meetings as appropriate

-Utilizes electronic medical record to accurately document case manager functions

-Conduct thorough assessments of patients'' needs, enabling more accurate diagnoses and targeted interventions.

- Streamline discharge planning processes, ensuring a smoother transition for patients back to their homes or other facilities.

-Conducted comprehensive patient assessments to identify care needs and develop individualized care plans.

-Collaborated with interdisciplinary teams to ensure coordinated patient care and optimize treatment outcomes.

-Implemented quality improvement initiatives to enhance assessment processes and patient satisfaction.

-Mentored nursing staff on best practices for patient evaluations and documentation accuracy.

-Streamlined documentation processes, reducing administrative burden while maintaining compliance with healthcare standards.

-Enhanced patient care by conducting comprehensive assessments and developing individualized care plans.

-Exhibited strong organizational skills when managing multiple competing priorities while maintaining a high standard of patient care.

-Improved interdisciplinary communication by collaborating with healthcare team members to ensure accurate and timely updates on patient progress.

-Demonstrated adaptability in managing a diverse caseload, effectively coordinating assessments for patients with varying needs and diagnoses.

-Increased accuracy of reimbursement claims by ensuring thorough completion of required assessments within mandated timeframes.

-Oversees the entire RAI process, including scheduling, completing, and transmitting MDS assessments to include admission, quarterly, annual and significant changes

-Ensures documentation meets Center for medicare and medicaid services (CMS) regulations and state requirements.

-Audits medical records, nursing notes and ADL flow sheets for accuracy to ensure appropriate reimbursement.

-Administered medications and treatments according to established protocols.

-Monitored patient vital signs and reported changes to healthcare team.

-Assisted in developing individualized care plans for diverse patient populations.

-Collaborated with multidisciplinary teams to enhance patient care outcomes.

-Provide quality skilled nursing in the home setting following established plan of care while following the physicians orders.

Conduct comprehensive evaluation of the patient and determine the skilled service needed in the home.

-after conducting assessment collect all necessary date needed to complete medicare oasis while following medicare guidelines

-Provide patient primary insurance company with relevant clinical date needed following their insurance eplan guidelines and instruct client on same.

-Act as a case manager when multiple serves are involved to insure correlation of all services to include nursing, physical therapy, occupational therapy, speech therapy, medical social worker, and home health aide.

-develop plan of care for assigned patient according to their needs and physicians orders depending on patient diagnosis.

-Maintain up to date clinical record including physicians orders and approved insurance visits according to their insurance plan.

-Maintain proficiency in all current home home procedures and technique to include in home iv therapy, chemotherapy, tpn, venipuncture, wound care, wound vacs, and education on current diagnosis.

-Administered medications and treatments as per physician orders, ensuring patient safety and adherence to protocols.

-Monitored vital signs and assessed patients' conditions, reporting changes to healthcare team promptly.

-Educated families on pediatric health issues, promoting understanding and compliance with care plans.

-Collaborated with multidisciplinary teams to develop personalized care plans for pediatric patients.

-Implemented infection control measures, reducing potential complications within pediatric units.

-Streamlined documentation processes, improving accuracy and efficiency in patient record-keeping systems.

-Educated children about their medical conditions in age-appropriate language, empowering them to take an active role in managing their health.

-Utilized critical thinking skills to quickly respond to emergency situations, stabilizing patients until further medical assistance arrived.

-Conducted thorough physical assessments to identify potential health concerns before they escalated into more serious conditions.

-Mentored new nurses and provided guidance on best practices in pediatric nursing, elevating the standard of care within the department.

-Provided education to parents on proper home care techniques, minimizing hospital readmissions and promoting long-term wellbeing.

-Interacted with child welfare personnel and social workers in cases involving concerns about overall well-being.