Linda Scott, BSN, RN, PHN

• Created the case management department in a new hospital, including training department members in case management procedures and protocols
• Assisted in the passing of state and federal licensure and certification, including Medicare.
• Accountable for admissions review, discharge planning, utilization review, and appeals to all insurance providers.
• Collaborated with multi-disciplinary team, patients/families, and physicians to optimize patient care and ensure timely discharge.
• Developed extensive training materials and workshops to provide knowledge of case management requirements, including EMTALA transfers, focusing on cost containment.
• Quarterly meetings with physicians from hospital, Care Transitions team and local clinics to review excessive LOS and determine how resources could be used to decrease these events.

Santa Rosa Memorial Hospital

• Facilitated interdisciplinary case conferences to assess patient's barriers to discharge, listing goals to be met before target discharge date.
• Initiated Medi-Cal, Disability, and Workers Compensation applications.
• Fostered cooperative relationships with patients, their families, physicians, therapists, ancillary staff, and community liaisons, improving length of stays (LOS).
• Educated contract physicians and rn travelers on procedures and protocols.

• Tracking data and reporting of Core Measures.
• Collaborated with the Business and Medical Records offices to insure re-imbursement for "Observation" patients.
• Coordinated EMTALA and 5150 transfers
• Reviewed audits and trending for Intensive Care, Acute, and "Swing" patients for the generation of quarterly reports, focusing on 30 day re-admissions, variance reviews for unnecessary days, and Observation status.
• Compiled Observation Guidelines and Protocol Manual for use in the Emergency department. Trained physicians and nursing staff on its application.

• Provided initial intake assessments for in-home supervision, and assessment of Home Care Option's (HCO) caregivers ability to comply with patient's contractual agreement.
• Communicate with primary care physician(s) for order changes and to schedule follow-up appointments. Contact equipment vendors for refills.
• Monitored patient's safety, ensured adequate nutritional intake, assessed caregiver's ability to over see patient's self-administration of medication.
• Reviewed patient logs, including vital signs, blood sugars and units of insulin administered. Filled medi-sets and checked medication expiration dates.
• Facilitated family interventions, as necessary.
• Reported to HCO daily.

• Dual position divided between Sutter's Administrative Services Organization (ASO) and Health Plan of the Redwoods (HPR), for daily monitoring of out-of-network patients, to repatriate when stable.
• Coordinated with physicians and staff at sending and receiving hospitals, for transfer orders, bed availability, and transport scheduling. Contact ambulance services if needed.
• Attended weekly meetings with HPR administrators to collaborate on optimizing systems and protocols for cost containment and patient satisfaction.
• Obtained authorization for therapies and equipment. Submitted high cost procedures and equipment requests to medical director for approval.
• Updated both managers daily.

• Provided complex discharge planning, utilization review, appeals and social work for Spinal cord injured (SCI) and Traumatic Brain injured (TBI) patients.
• Facilitated interdisciplinary team conferences to assess patient progress and clarify needed improvement before transfer or discharge.
• Lead family meetings to provide education on patient's needs at discharge, and to determine family's ability and to participate in therapy and nursing training, in the hospital and at home.
• Obtained alternate level of care for patients, as needed.
• Coordinated with worker's comp case managers, lawyers, physicians, and facility staff to ensure safe transition.
• Created a TBI resource learning library for patient's family members.
• Produced a "San Quentin State Prison Patient Guidelines" , with administrators from San Quentin correctional facility, to ensure safety of staff and fair treatment of inmates.