Patricia Cole

• Developed and modified patient care plans and assisted interdisciplinary team in identifying client needs and goals to determine priorities of care.
• Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
• Reduced hospital readmission rates through effective case management and patient education on self-care techniques.
• Managed complex cases involving multiple comorbidities, requiring close monitoring and coordination of various healthcare services.
• Streamlined discharge planning processes, ensuring a smoother transition for patients back to their homes or other facilities.

• Developed and modified patient care plans and assisted interdisciplinary team in identifying client needs and goals to determine priorities of care.
• Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
• Educated patients and families on available community resources, facilitating access to necessary support services.
• Streamlined discharge planning processes, ensuring a smoother transition for patients back to their homes or other facilities.
• Self-motivated, with a strong sense of personal responsibility.

• Nov 2013-Dec 2020 RN Case Manager

Daily reviews for meeting continued inpatient stay base on MCR guidlines with Interqual. Assessment of new patients. Discharge planning. Insurance authorization for hoptial stay. Provided ER and Hospitalist with guidance for admission status, OBS vs Inpatient.

• Sept 2010-Nov 2013 MDS Coordinator

Scheduled MDS reviews and completion of required MDS for skilled nursing facilities, daily patient interaction, assisted with daily patient care and medication administration. Supervised PR, LPN and CNA staff

• Jan 2008-Sept 2010 Home Health Nurse Manager

Coordinated daily HH schedule for nurses and aides, HH patient visits as needed including wound care, IV administration, teaching and lab draws

• Dec 2007-Jan 2008 LPN Staff Nurse

Daily nursing duties, physical assessments, medication administration, wound care, discharge planning

• May 1995-Dec 2007 Non Clinical positions within Citizens Memorial Hospital. Dietary services, Accounts Payable and Human Resources Representative