Responsible for coordinating Resident Assessment Instrument (RAI) process ensuring accurate and timely completion of resident assessment in accordance with Medicare, Medicaid, OBRA and other payer program requirements
Review/audit supporting documents for appropriate coding of diagnosis, procedures, treatment and care provided to ensure assessments accurately reflect optimal reimbursement for services provided
Proactively communicate with clinician/IDT to clarify clinical diagnosis terminology, ICD 10 codes and inaccurate or unclear documentation
Collaborate and educate interdisciplinary team to ensure basic knowledge of assessment and reporting services provided are in accordance with CMS guidelines
Review State Case Mix Index report, Quality Measure and Value-based Purchasing report, analyze, evaluate, correct, develop and implement tasks to improve outcome
Plan, organize, schedule and submit due Minimum Data Set (Obra and PDPM) per RAI / CMS guideline and develop care plans
Collaborate with managed care to establish baseline plan of care, update clinical/rehabilitation progress, determine length of stay and plan discharge process
Correspond to RAC audit, managed care post pay medical record request, denial of payment by submitting requested documentations and formal dispute letter.
RN, Wound Care Certified
Christian Health Care Center
Lynden, WA
11.2019 - Current
Manages facility wound care, including assessment, treatment planning, evaluation of treatment effectiveness, coordination of care with interdisciplinary team, and documentation.
Wounds treated include various stages of pressure injury, venous stasis ulcer, arterial ulcer, diabetic ulcer, moisture associated skin damage, surgical wound, cancerous lesions, skin tear etc
Educate/train licensed nurses on basic knowledge of various wounds, wound assessment, treatment, monitoring and infection control
Provide education to patient/family risks versus benefits of compliance with professional recommendation to optimize wound healing.
RN, Team Leader
Christian Health Care Center
Lynden, WA
07.2015 - Current
Intake new admissions, develop baseline care plan, implement and evaluate nursing interventions with ongoing communication/collaboration within interdisciplinary team to deliver optimum care to patients, and coordinate discharge process including reviewing order, care instruction, providing education to patients and family to ensure smooth transition to step down level of care
Direct and delegate work assignment to nursing assistants and ancillary team to optimize patient care outcome
Skilled care nursing responsibilities include medication management (oral, intramuscular, subcutaneous, intravenous), monitoring and treating medical and post op surgical patients, surgical wound care, acute and chronic wound care, blood draw, tube feeding, colostomy care, catheter insertion and care, suction, oxygen therapy, mental and hospice patient care, implementing preventative measures and patient/family education.
Director of Administration
Imitating Christ Ministry
Surry, British Columbia
07.2009 - 08.2013
Planned and coordinated annual, seasonal missionary training programs
Developed and implemented organizational policies and procedures