Rebecca Franklin

Currently the RN Case Manager for in-patient medical unit, and swing bed unit at Cottage Grove community access hospital. I manage the swing program including reviewing all referrals for swing eligibility, manage the swing programs MCR required elements, provide all coordination and discharge planning for the in-pt and swing patients.

I evaluate patients progress meeting goals set by the IDT, lead IDT case conferences weekly, and lead IDT rounds.

I provide assistance also to the Emergency Department for any case management needs.

• Worked with suppliers and vendors on provision of medical equipment, items and services.
• Created individualized care plans based on nursing diagnosis and incorporated appropriate nursing methods to achieve positive outcomes.

RN Case Manager currently covering ICU and Step down unit, general surgery, Neurology, CDU, Orthopedics, Oregon heart and vascular unit and adult medicine.

Thorough assessment and management and coordination of all discharge planning.

• Current Supervisor for Optum RN Case Management program for Oregon and South Washington market. Responsible for Oregon market RN Case Managers supervision, schedules, leadership, training and mentoring and program and processes development
• Assisted in development in ALF program and case Managed patients across continuum in all levels of care transitions, with high focus on hospital prevention, including direct skilled admission, readmission prevention, and 5 start quality measure outcomes
• Effective successful launch of Optum IESNP program in over 10 new ALF communities. Program began with 1 ALF and now consists currently of 28 Assisted Living communities in Oregon and South Washington
• Participates in Utilization Management, 5 star quality measures, leadership and program development committees

• Managed Daily operations for RN Case Management Dept, CDMP, and for limited time Utilization review, and Diabetic education for operational effectiveness and high quality outcomes
• Daily oversight and leadership above Departments providing support and guidance to needs of Case Management, CDMP, diabetic educator and medical staff for improved hospital and patient outcomes
• Managed RN Case Management and CDMP schedules with creative efforts to maintain quality staffing under budget and assisted with transition to a 2 campus model
• Hired new RN Case Managers and provided orientation and mentoring ensuring high quality outcomes and understanding of RN Case Managers role, processes, LOS management and Palliative care
• Built effective trusting relationships with hospital leadership, staff and community partners over 29+ years

• Initial pilot RN for Case Management development. Case managed patients including screening, assessment of needs, discharge planning, and end of life care and POLST completion
• Coordination of family conferences
• Daily screening for needs, and barriers to timely safe discharge
• Review functional status and initiate any services or intervention needed for efficient discharge and delay prevention
• Clinical coordination of all care needs including home health, home infusion, hospice, ambulatory infusion, wound care, medical equipment, medication assistance and end of life discussion and planning, and more
• Strong emphasis on LOS management
• Strong partnership with Hospitalist and Medical Social work

• Responsibilities for admission RN included efficient admission gathering and documenting all information upon arriving to floor
• Immediate report off to ICT with status, and report
• Communicated with hospitalist with request for needed orders to begin effective discharge planning immediately. ie: PT/OT, Diabetic education, wound care evaluation, dietician consult, etc
• Responsibilities for discharge RN included ensuring all needs were addressed for discharge, medication review for accuracy, coordination of any identified needs, and F/U phone calls post discharge

• Direct nursing care of adult, Geriatric and Pediatric population with acute medical illness, providing highest quality care to patients and support to their families
• Provided assistance with any surgical procedures
• Provided comfort care during end of life
• Facilitated during days charge nurse off. Management of unit staffing, and coordination of emergency admission and interdepartmental transfers
•