Misty Smelser
San Antonio,TX
Summary
Patient-oriented Nurse with 29 years of diverse experience in direct patient care, staff supervision and department operations. Skilled at multitasking and prioritizing patient needs and daily assignments. Offering expertise with hospice specialty.
Overview
12
12
years of professional experience
Work History
Admission Nurse
Harbour Hospice
02.2024 - Current
- Streamlined admissions process for increased efficiency and reduced waiting times.
- Assisted in developing new policies and procedures, enhancing overall quality of patient care during admission process.
- Coordinated with multidisciplinary teams to ensure seamless transitions for patients entering various hospital departments.
Director of Clinical Services
Healthcare Pathways Equity and Management Group
05.2022 - 01.2024
- Maintain current knowledge base of hospice regulations and incorporate into clinical practice
- Experience in 80+ TPE ADRs as well as CERT ADRs with high approval determinations
- Clinical lead for approximately 20 surveys with experience in startup, license renewal, clearing conditional tags, multiple unannounced follow up visits 6 months post survey
- Many deficiency free survey results
- Responsible for writing and submitting action plan post survey for any deficiencies cited
- Responsible for inservicing, implementing, and auditing to ensure action plan is followed through to completion
- Participate in revenue cycle management
- Supervise admission/discharge processes to ensure eligibility criteria were being met according to CMS guidelines
- Conducted comprehensive audits to ensure clinical services adhered to established standards, maintaining high level of accountability across the organization.
- Developed, implemented, revised, and evaluated policies and procedures.
- Financial reports: Medicare cost reporting, LOS analysis etc
- Analyze reports and adjust clinical operations accordingly (Pepper report, Medicare compare, EMR- monthly, quarterly, satisfaction surveys, etc)
- Hiring and training all clinicians.
- Enhanced patient care quality by implementing evidence-based clinical practices and protocols.
- Streamlined clinical operations for improved efficiency through effective staff management and resource allocation.
- Achieved accreditation compliance by maintaining up-to-date knowledge of healthcare regulations and ensuring adherence to industry standards.
- Improved interdisciplinary collaboration, fostering strong working relationships among medical professionals for optimal patient outcomes.
- Increased staff retention rates through effective leadership, mentoring, and professional development opportunities.
- Promoted culture of continuous improvement by encouraging staff input on process enhancements and best practices adoption.
- Fostered inclusive work environment that valued diversity, leading to increased employee satisfaction and engagement levels.
- Oversaw recruitment efforts to attract top talent in the field, contributing to a highly skilled workforce capable of delivering excellent patient care services.
- Spearheaded initiatives aimed at enhancing community outreach efforts, increasing visibility and reputation within local market as well as beyond.
- Established rigorous quality assurance processes, monitoring key performance indicators closely to ensure consistent delivery of high-quality clinical services across all departments.
Operations Manager
Healthcare Pathways Equity and Management Group
07.2020 - 05.2022
- Reduced turnaround time for project completion through effective resource allocation and team management.
- Enhanced customer satisfaction by establishing clear communication channels and addressing concerns promptly.
- Establish or implement departmental policies, goals, objectives, or procedures in conjunction with board members, organization officials, or staff member
- Develop, implement, adjust, and monitor pandemic response according to local, state, and federal guidelines
- Oversee scheduling for all disciplines and ensure that visits were made, if not appropriate documentation was made in timely manner
- Oversee NOE submission process to ensure compliance
- Achieved higher employee retention rates by fostering positive work environment and providing opportunities for professional growth.
- Conducted regular performance reviews, identifying areas for improvement and developing action plans to address them.
- Led successful change initiatives, ensuring seamless transitions during organizational restructuring efforts.
- Improved operational efficiency by streamlining processes and implementing cost-saving measures.
RN Case Manager
The Hospice Group
01.2015 - 01.2017
- Evaluating patient's physical condition
- Developing appropriate care plan to address all medical needs and social services
- Coordinating all efforts of medical and nursing team members
- Providing appropriate care
- Addressing psychological needs of patients
- Counseling and participating in education efforts
- Providing hands-on nursing care to patients
- Providing support and counseling to clients
- Implementing IDT efforts
- Supervision of aid and lvn
- On call responsibilities.
Assistant Director of Health Services
Trilogy Health Services
09.2014 - 03.2015
- Responsible for staff development and daily staffing within PPD budget allowances
- Chair Clinically at Risk meeting
- Communicating with family members regarding concerns
- Responsible for follow-up on previous care concerns with residents, family members, and staff
- Monitoring daily/weekly/monthly weights and analysis of weights as related to current clinical condition; coordinate care with RD as indicated
- Liaison between other department heads to nursing staff to ensure optimal communication
- Conducted abuse investigation and reporting to state board of health
- Responsible for weekly wound measurements and ensuring all healing modalities are implemented
- Monitor nursing hours daily and reconcile schedule discrepancies.
Clinical Lead
Trilogy Health Services
03.2014 - 09.2014
- Trained on the Smartlinx scheduling system and worked in conjunction with Scheduling Coordinator to fully implement software within Waterford Place Health Campus (training campus)
- Learned budgeting process and how to adjust staffing hours related to PPD as well as plan for and negotiate new budget
- Chaired several meetings that pertain both to financial issues (medicare, CCM) and clinical issues (CAR)
- Familiarized with nursing Regulation (Watermelon Book), familiarized with Trilogy policy and procedure (Clinical Programs Manual), established a network of resources as support system (within AIT/CLF group, home office, training campus, and home campus)
- Developed QAA action plan and implemented interventions in the plan, reinforced interventions through consistency and follow-up and evaluate data in subsequent month's QAA
- Maintained DHS report for Legacy and Assisted Living
- Organized and supervised Level of Care while training a newly hired AL coordinator, attended Resident 1st meetings to discuss Level of Care and address concerns
- Led deficiency free survey by ISDH
- Successfully implemented introduction of staff nurses into CAR process.
MDS Coordinator
Trilogy Health Services
06.2012 - 09.2014
- Raised CMI to above state average for first time since campus opened
- Chaired morning CCM-including clinical aspects - annual survey with 3 citations with only paper compliance without re-visit
- Maintained Medicare reimbursement rate at budget
- Implemented I-Care Plans - no citations related to care plan
- Chaired Medicare Meeting
- Restructured weight program and brought it into compliance
- Coordinated Restorative Nursing Services
- Educated nursing staff on variety of topics ranging from ads to tracheotomy care and knowing difference between left sided heart failure and right sided heart failure
- Attended to all Resident 1st meetings and follow-up on concern or service recovery process and educated families and residents about wide range of topics.
Education
Associate's Degree - Science of Nursing -
Ivy Tech Community College
Kokomo, Indiana12.2010
LPN -
Ivy Tech Community College
Lafayette, Indiana12.1994
Skills
- Medical Charting
- End of life care
- First Aid
- Clinical judgment
- Healthcare Software Proficiency
- Needs Assessment
Quote
I attribute my success to this: I never gave or took an excuse
Extracurricular Activities
Personalized executive training program for a year in Louisville, Kentucky following nursing school
Timeline
Admission Nurse
Harbour Hospice
02.2024 - Current
Director of Clinical Services
Healthcare Pathways Equity and Management Group
05.2022 - 01.2024
Operations Manager
Healthcare Pathways Equity and Management Group
07.2020 - 05.2022
RN Case Manager
The Hospice Group
01.2015 - 01.2017
Assistant Director of Health Services
Trilogy Health Services
09.2014 - 03.2015
Clinical Lead
Trilogy Health Services
03.2014 - 09.2014
MDS Coordinator
Trilogy Health Services
06.2012 - 09.2014
Associate's Degree - Science of Nursing -
Ivy Tech Community College
LPN -
Ivy Tech Community College
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