Gabrielle Nichols
San Francisco Bay Area,CA
Summary
Home healthcare operations and quality assurance leader with agency administration, clinical compliance, and performance improvement experience. Leads accreditation readiness, EMR workflow reviews, OASIS accuracy audits, and staff training. Improves regulatory compliance, supports CMS Star rating performance, and strengthens patient care delivery efficiency.
Overview
1
1
Certification
2027
2027
years of professional experience
Work History
Founder & Operations / QA Lead
Fathom Home Health Solutions, LLC
San Francisco Bay Area, CA
08.2018 - Current
- Founded and built a healthcare solutions company delivering tech-enabled support, quality assurance, and compliance services to home health agencies.
- Spearheaded performance improvement initiatives that elevated client CMS Star Ratings from 2.5 to 4.0 in under 12 months.
- Guided multiple healthcare agencies through regulatory surveys, cumulatively passing dozens of accreditation audits (Joint Commission, ACHC, CHAP, Kaiser).
- Collaborated with clinical directors and executive leadership to align operational workflows and OASIS accuracy, securing full accreditation survey approvals and resolving federal ADR audits.
- Developed and facilitated training programs in quality assurance and cross-functional collaboration for clinical record auditors, ensuring uniform standards for regulatory compliance and audit accuracy.
- Provided comprehensive EMR chart reviews, medical coding, OASIS accuracy validation, and staff education to streamline intake, scheduling, and billing cycles.
- Partnered with clinical managers and home health owners to evaluate staffing needs and oversee high-acuity caseloads exceeding 120 patients, ensuring seamless post-acute discharge coordination.
- Developed business plans or processes for efficient and effective home health operations and patient-centered service delivery.
Operations Manager & QA / Clinical Records Reviewer
Helenium Home Health, Inc.
San Jose, CA
04.2014 - 03.2018
- Directed day-to-day operations for a comprehensive home health agency, improving service quality and financial viability.
- Developed business plans or processes for efficient and effective home health operations and patient-centered service delivery.
- Supervised day-to-day workflow of employees in order to maximize productivity and maintain quality standards.
- Resolved customer complaints in a timely manner while ensuring customer satisfaction remained at optimal levels.
- Oversaw QA review of clinical documentation, OASIS data submission, 485 Plans of Care, 30-day progress notes, and billing compliance to ensure regulatory adherence.
- Coordinated team efforts to achieve successful Joint Commission survey, contributing to 60% census increase.
- Managed onboarding and training for administrative staff, field RNs, therapists, and medical social workers to enhance operational readiness.
Performance Improvement Coordinator
Warm Springs Home Health, Inc.
Fremont, CA
01.2009 - 04.2014
- Spearheaded quality improvement activities and conducted clinical record reviews, ensuring compliance with state and federal regulations.
- Educated and trained personnel across clinician, quality assurance, intake, referral, staffing, and medical records departments, enhancing overall team competency.
- Maintained information records management systems, achieving full alignment with Joint Commission standards.
QA / Clinical Records Utilization Reviewer
Warm Springs Home Health, Inc.
Fremont, CA
01.2009 - 04.2014
- Conducted utilization reviews and clinical record audits to verify medical necessity, coding accuracy, and regulatory compliance in home health care plans, enhancing quality assurance processes.
- Verified medical necessity against care plans and clinical documentation.
- Evaluated utilization requests for home health services at Warm Springs Home Health.
- Managed authorization processes by collaborating with nurses, therapists, and care managers.
Health Information Staff
Warm Springs Home Health, Inc.
Fremont, CA
01.2009 - 04.2014
- Worked with clinical records team to file and retrieve clinical records accurately and on time, while supporting compliance with federal, state, and Joint Commission regulations.
- Assisted information records manager with updates to clinical records information system, improving data integrity and access.
- Maintained and updated filing, inventory and database systems, manually or using computer.
- Reviewed files, records and other documents to obtain information or respond to requests.
- Observed client comfort levels and reported concerns to nursing staff.
- Coordinated employee schedules and maintained accurate timekeeping records.
- Trained newly hired employees regarding company policies and operations.
- Responded to customer queries and complaints to promote overall satisfaction.
Referral & Intake
Warm Springs Home Health, Inc.
Fremont, CA
01.2009 - 04.2014
- Cultivated and sustained strong relationships with healthcare referral sources, enhancing collaboration and patient access to services.
- Engaged with patients, families, referral sources, vendors, and physicians to guarantee timely and appropriate patient care.
- Coordinated with patient care managers to facilitate seamless transitions for patients into home care, ensuring continuity of care.
- Identified payer sources, verified insurance eligibility and financial status, and assigned correct pay types.
- Entered and updated patient health information in Kinnser's EMR Software.
Staffing Coordinator
Warm Springs Home Health, Inc.
Fremont, CA
01.2009 - 04.2014
- Coordinated employee assignments based on availability, skill level, and geographical coverage to optimize staffing.
- Communicated with field clinicians on care frequency, duration, resumption, recertification, and evaluation to ensure continuity of care.
- Utilized Kinnsers software to assign clinical documentation, track visit schedules, and record assignment refusals.
- Followed up with clinicians on schedule changes and patient care concerns to maintain service quality.
Human Resources
Warm Springs Home Health, Inc.
Fremont, CA
01.2009 - 04.2014
- Directed candidate selection and recruitment processes for open requisitions across clinical and administrative staff.
- Collaborated with management to evaluate recruiting needs and design targeted recruitment strategies that align with organizational goals.
- Developed and implemented orientation and professional development programs to enhance employee engagement and retention.
- Facilitated in-service education and training sessions in collaboration with clinical and administrative leadership to ensure compliance and staff competency.
- Ensured strict compliance with federal, state, and Joint Commission human resources regulations.
- Processed all I-9 documentation and maintained confidential employee records.
Assistant Production Designer | Philippines
Unitel Productions, Inc.
, Philippines
1997 - 2005
- Collaborated with directors, producers, and creative teams to deliver cohesive visual narratives for major multinational brand accounts.
- Designed visual concepts, set structures, and production aesthetics for national television commercials and feature films.
- Developed set concepts, sketches, and visual references for creative teams.
- Coordinated with directors, producers, and art staff on design requirements.
- Selected props, furnishings, and finishes to enhance set designs and align with project style and tone.
- Developed layout plans and production drawings to guide set construction teams in executing design visions.
Physical Therapist
Cadiz City District Hospital
, Philippines
01.1996 - 01.1997
- Delivered physical therapy treatment and rehabilitation programs to enhance recovery for acute care and outpatient hospital patients.
- Developed individualized treatment plans for inpatient and outpatient physical therapy care.
- Administered therapeutic exercises, manual therapy, and gait training procedures.
- Evaluated patient mobility and functional limitations in district hospital rehabilitation services.
- Provided therapeutic pain relief to patients to alleviate discomfort and promote recovery. to patients involving moist packs, foam rollers, soothing balms and infrared lamps.
Education
Bachelor of Science - Physical Therapy
Our Lady of Fatima University
PhilippinesSkills
- Healthcare compliance
- Regulatory adherence
- Quality assurance
- Utilization review
- Clinical records management
- EMR review
- Process improvement
- Operations management
- Staff training
- Team leadership
- Customer focus
- Team building
Certification
- Specialized Training & Certifications:
- OASIS Assessment & Accuracy (C1 / C2 / E / E1 / E2)
- ICD-9 / ICD-10 Medical Coding
- HIPAA Compliance & High Alert / High Risk Management
- Medicare Conditions of Participation & Survey Preparedness
- Home Health & Hospice Licensing, Certification Requirements & Quality Management & Performance Improvement (QAPI)
Timeline
Founder & Operations / QA Lead
Fathom Home Health Solutions, LLC
08.2018 - Current
Operations Manager & QA / Clinical Records Reviewer
Helenium Home Health, Inc.
04.2014 - 03.2018
Performance Improvement Coordinator
Warm Springs Home Health, Inc.
01.2009 - 04.2014
QA / Clinical Records Utilization Reviewer
Warm Springs Home Health, Inc.
01.2009 - 04.2014
Health Information Staff
Warm Springs Home Health, Inc.
01.2009 - 04.2014
Referral & Intake
Warm Springs Home Health, Inc.
01.2009 - 04.2014
Staffing Coordinator
Warm Springs Home Health, Inc.
01.2009 - 04.2014
Human Resources
Warm Springs Home Health, Inc.
01.2009 - 04.2014
Physical Therapist
Cadiz City District Hospital
01.1996 - 01.1997
Assistant Production Designer | Philippines
Unitel Productions, Inc.
1997 - 2005
Bachelor of Science - Physical Therapy
Our Lady of Fatima University