Karen Denise Joiner
El Paso,TX
Summary
A Bachelor’s prepared nurse with more than 19 years of experience in various nursing specialties, including nursing hospice, intensive care, care coordination, and many nursing leadership roles. I am an enthusiastic professional with a positive attitude and a strong work ethic. I am always willing to expand my nursing skills and continue to expand my knowledge base. I am very passionate about patient and family care.
Knowledgeable in geratiric and chronic disease with solid background in case management within healthcare settings. Proven ability to coordinate patient care and navigate complex healthcare systems effectively. Demonstrated expertise in patient advocacy and communication.
Overview
1
1
Certification
19
19
years of professional experience
Work History
Registered Nurse – Case Manager
Tendercare Home Health and Hospice
El Paso, TX
07.2023 - Current
- Review records and conduct assessments with new admits assessing prior functionality and future needs
- Conduct client therapeutic medical, psycho-social, and psychiatric assessments and determine the need for treatment options by working with an interdisciplinary team
- Head to toes assessments completed
- Reconcile medications and teaching
- Coordinate care with DME companies, pharmacies, and physicians.
- Teaching performed with patients/families on the disease process
- Administer medications as ordered, ie. PICC lines, Parental, Enteral, PO
- Teach medication management, wound care, tube feeding schedules and processes, disease process, and symptom management
- Participate in interdisciplinary team meetings/case conferences, in-services, and staff meetings.
- Document in EMR record accurately and timely, contact physicians with patient changes, and receive and write verbal orders
- Update the plan of care as needed and notify the physician of signs and symptom changes in patient status, report the need for add-on services
- Coordinate with other healthcare providers to enhance continuity of care
- Complete all admission procedures, recertifications, and follow-up assessments timely and accurately
- Conduct discharge assessments and ensure that patient teaching is completed with discharge orders and instructions
- Complete OASIS/ HIS documentation
- Mentored junior staff in case management techniques, fostering professional development.
- Conduct supervisory visits with HHA and LVN/LPNs per regulatory rules.
- Coordinated patient care plans to ensure holistic support and resource utilization.
- Conducted thorough assessments to identify patient needs and develop tailored interventions.
- Collaborated with interdisciplinary teams to optimize patient outcomes and streamline processes.
- Educated patients and families on care strategies, enhancing understanding and compliance.
- Monitored ongoing care delivery, adjusting plans based on changing patient conditions.
- Implemented quality improvement initiatives, enhancing service delivery standards within the hospice program.
- Advocated for patients' rights and preferences, ensuring dignity and respect in care decisions.
Registered Nurse – Executive Director
Ambercare Hospice
04.2022 - 07.2023
- Maintain positive internal and external customer service relationships
- Delegate agency programs to responsible administrative and supervisory personnel
- Monitor day–to–day regulatory and reimbursement requirements
- Develop and implement administrative policies and procedures
- Establish functions and qualifications for all personnel
- Determine staffing needs and patterns for maximizing personnel potential
- Oversee compliance with personnel policies and procedures
- Negotiate and execute contracts with community providers for service and monitor program compliance
- Actively participate in continuous quality improvement, educational programs, and staff meetings
- Document in HCHB, ADP, and Smart sheet
Registered Nurse – Manager of Case Management
Del Sol Medical Center
09.2021 - 04.2022
- In addition to the case management role, create the schedule and update in Facility scheduler for staff in the case management department
- Reviewing long lengths of stays with the CM and SW and discussing solutions to help get the patient move to a post-acute setting
- Any patient in house >20 days is reviewed with Interqual, Team to ensure that they are having weekly conferences with the patient/family to ensure that goals are being discussed and review the clinical information
- Report to the division all lengths of stay longer than 20 days
- Review documentation for observations of patients to ensure they are meeting the criteria for observation or admission and work with the team and physicians to get them appropriately admitted or discharged within the time constraints
- Meet daily with the CMO and Hospitalists to review barriers and find solutions to discharges
- Plan monthly staff meetings
- Train new staff on processes, and software such as Midas, NaviHealth and Meditech
- Set up new staff in Esaf
- Check and update Kronos for timekeeping for staff and ensure it is accurate
Registered Nurse – Case Manager
Del Sol Medical Center
08.2019 - 09.2021
- Review records and conduct assessments with new admits assessing prior functionality and future needs
- Conduct client therapeutic medical, psycho-social, and psychiatric assessments and determine the need to treatment options by working with an interdisciplinary team
- Review medical records to verify client patient progress and help to assist with determining proper placement in transitional care
- Prepare discharge by reviewing and coordinating post-discharge requirements, orienting and training family members, and providing resources
- Coordinate care transition of care between hospitals when transferring to a higher level of care
Registered Nurse – Clinical Integration Specialist
Encompass Health
Dallas, TX
02.2015 - 08.2019
- Responsible for supporting assimilation, integration, and training process for newly acquired agency staff.
- Support orientation and training of new staff on company policies, procedures, standard operating procedures, and deployment of HCHB software, focusing on clinical staff members.
- Participate in pre-planning meetings for onsite training goals.
- Present classroom-style training sessions on the use of the EMR
- Oversite of HIS, OASIS, ICD-10 coding, and patient-specific care planning
- Responsible for communicating regular updates on the status of training and orientation, integration challenges, and overall success of the project.
- Ensure that skill competencies, written competency exams, and in-services are current and compliant with CMS and applicable regulatory and accreditation entities.
- Assist with workflow to ensure Medicare, Medicaid, and Private Insurance information is correct and authorized.
- Responsible for communicating updates on goals of training reached
Hospice Director
Encompass Health
Carlsbad, NM
08.2016 - 03.2018
- Supervise day-to-day office and clinical operations, educate and train staff with in-services
- Approve on-call schedules, review and approve documentation for scheduling and billing, manage financial budgets to control unbilled and ensure the fiscal solvency of the agency by controlling costs of labor, DME, and medications.
- Review and approve accounts payable and payroll.
- Work closely with RVP and Administrator on review and follow-up on complaints, infections, and incidents for Quality measures.
- Complete chart audits, ensure agency preparedness for federal and state surveys and participate in agency disaster preparedness.
- Provide monthly Aide in-service, volunteer in-service, general staff meetings, and monthly Case manager meetings.
- Completing weekly agency audit report
- Participate in community awareness and education programs
- Participate in administrative on-call as a support to the on-call nurse and to provide software management related to processing intakes, reviewing evaluation packets, and scheduling, moving & reassigning visits to ensure the smooth function of the agency during off hours.
- Ensure that end-of-episode billing is completed timely and outstanding claims are kept to a minimum; the goal is 10% of revenue or less.
ACO Care Coordinator
Artesia General Hospital
06.2016 - 08.2016
- Coordinate care transitions between Acute & post-acute care providers
- Coordinate follow-up appointments and provide follow-up calls to ensure patient reminders of upcoming appointments
- Assist in preventing duplication of resources and prevent rehospitalizations by making regular calls with patient
- Help with patient understanding of self-care needs, poor awareness of red flags regarding own conditions, and the implications of non-compliance
- Encourage setting care goals and help patients assume a more active role in their own care and a team-based attitude
- Provide care transition coaching
- Visit the patient at the bedside before discharge and at follow-up appointments
- Assess patient’s ability to participate in their own care and help engage them in the process
- Explain the process, provide education, and answer questions
- Schedule regular calls and occasional home visits to prevent rehospitalization
- Work with PCPs to encourage regular preventative screenings and follow-up appointments
- Communicate with PCPs on any changes or concerns
RN Field Nurse PRN
Encompass Home Health and Hospice
Carlsbad, NM
02.2016 - 08.2016
- Head to toes assessments completed
- Reconcile medications and teaching
- Coordinate care with DME companies, pharmacies, and physicians.
- Teaching performed with patients/families on the disease process
- Administer medications as ordered, ie. PICC lines, Parental, Enteral, PO
- Teach medication management, wound care, tube feeding schedules and processes, disease process, and symptom management
- Participate in interdisciplinary team meetings/case conferences, in-services, and staff meetings.
- Document in EMR record accurately and timely, contact physicians with patient changes, and receive and write verbal orders
- Update the plan of care as needed and notify the physician of signs and symptom changes in patient status, the report need for add-on services
- Coordinate with other healthcare providers to enhance continuity of care
- Complete all admission procedures, recertifications, and follow-up assessments timely and accurately
- Conduct discharge assessments and ensure that patient teaching is completed with discharge orders and instructions
- Complete OASIS/ HIS documentation
- Ensure missed visits are rescheduled
- Ensure lab tests are obtained, stored, and transported per protocol, review and evaluate labs and ensure that the physician is notified.
- Conduct supervisory visits with HHA and LVN/LPNs per regulatory rules.
Hospice Director
Interim HealthCare
Pampa, TX
08.2010 - 11.2015
- Supervise day-to-day office and clinical operations
- Educate and train staff with in-services
- Approve on-call schedules
- Review and approve documentation for scheduling and billing
- Manage financial budgets to control unbilled and ensure the fiscal solvency of the agency by controlling costs of labor, DME, and medications.
- Review and approve accounts payable and payroll.
- Work with the Administrator closely to review and follow up on complaints, infections, and incidents for Quality measures.
- Complete chart audits, ensure agency preparedness for federal and state surveys and participate in agency disaster preparedness.
- Function as a staff nurse when necessary
- Provide Head to toe assessments
- Medication reconciliation and teaching
- Administer medications as directed by the physician
- Coordinate care of patients with physician, pt/family, facility staff, and hospital
- Provide teaching in the community for fall prevention, hospice knowledge
- Coordinate DME and other therapies as ordered
- Provide teaching on disease process and patient safety
Patient Care Manager
Interim HealthCare
Amarillo, TX
09.2009 - 08.2010
- Perform case management with a small patient load
- Head to toes assessments completed
- Reconcile medications and teaching
- Coordinate care with DME companies, pharmacies, and physicians.
- Teaching performed with patients/ families on disease process based on their learning ability.
- Participate in interdisciplinary team meetings
- Assist Director with chart audits
- Orienting and onboarding new staff
- Participate in on-call rotation
RN Case Manager
BSA Health System
Pampa, TX
01.2008 - 09.2009
- Head to toes assessments completed
- Reconcile medications and teaching
- Coordinate care with DME companies, pharmacies, and physicians.
- Teaching performed with patients/families on disease process based on their learning ability.
- Participate in interdisciplinary team meetings, in-services, and staff meetings.
- Document in EMR record accurately and timely, contact physicians with patient changes, and receive and write verbal orders
- Review and verify weekly scheduled visits to ensure accuracy
- Update the plan of care as needed and notify the physician of signs and symptom changes in patient status, report the need for add-on services
- Coordinate with other healthcare providers to enhance continuity of care
- Follow policy and procedures in timely updates of software/mobile devices
- Complete all admission procedures, recertifications, and follow-up assessments timely and accurately
- Conduct discharge assessments and ensure that patient teaching is completed with discharge orders and instructions
- Complete OASIS/ HIS documentation
- Ensure missed visits are rescheduled
- Ensure lab tests are obtained, stored, and transported per protocol, review and evaluate labs and ensure that the physician is notified.
- Conduct supervisory visits with HHA and LVN/LPNs per regulatory rules
ICU RN
BSA HOSPITAL
Amarillo, TX
07.2007 - 12.2007
- Head to toes assessments
- Monitor v/s
- Administer PO, IM, and IV medications and monitor for adverse signs and symptoms
- Administer blood and blood products and monitor for adverse symptoms
- Participate in the coordination of care with an interdisciplinary team
- Effective communication with patients, providers, team members, and families
- Administer parental and tube feedings as ordered, Manage hemodialysis and peritoneal dialysis
Education
Bachelor's in Nursing -
West Texas A & M University
Canyon, TX05.2007
Associate in General - undefined
Clarendon College
Clarendon, TX05.2004
Skills
- Time Management
- Microsoft Office (10 years)
- Direct Patient Care
- Medical-Surgical Nursing
- Intensive Care Nursing
- Hospice Nursing
- Home Health Nursing
- Nursing Management
- Interdisciplinary Team care
- Therapeutic Communication
- Palliative care
- Electronic Medical Records
- Medication Administration
- Mentoring
- Organization
- Leadership
- InterQual
- Meditech
- Homecare homebase
- ADP
- Direct patient care
- Goal setting
- Emotional intelligence
- Care coordination
- EMR / EHR
- Geriatric care
- Discharge planning
- Case evaluation
- Patient assessments
- Staff management
- Resource utilization
- Patient care planning
- Referral coordination
- Clinical assessment
Certification
- RN State: TX Expires: April 2024
- BLS-American Heart Association Expires: June 2025
Timeline
Registered Nurse – Case Manager
Tendercare Home Health and Hospice
07.2023 - Current
Registered Nurse – Executive Director
Ambercare Hospice
04.2022 - 07.2023
Registered Nurse – Manager of Case Management
Del Sol Medical Center
09.2021 - 04.2022
Registered Nurse – Case Manager
Del Sol Medical Center
08.2019 - 09.2021
Hospice Director
Encompass Health
08.2016 - 03.2018
ACO Care Coordinator
Artesia General Hospital
06.2016 - 08.2016
RN Field Nurse PRN
Encompass Home Health and Hospice
02.2016 - 08.2016
Registered Nurse – Clinical Integration Specialist
Encompass Health
02.2015 - 08.2019
Hospice Director
Interim HealthCare
08.2010 - 11.2015
Patient Care Manager
Interim HealthCare
09.2009 - 08.2010
RN Case Manager
BSA Health System
01.2008 - 09.2009
ICU RN
BSA HOSPITAL
07.2007 - 12.2007
Associate in General - undefined
Clarendon College
Bachelor's in Nursing -
West Texas A & M University