Private RN Consulting for Long Term Care Facilities
Contracted with companies and facilities to provide facilities in crisis with clinical operations oversight and system changes to return to substantial compliance with State and Federal regulations. Facilities are trained in how to be able to provide a high quality of nursing care and services by the use of the RAI and RN Care Management. Responsibilities include Plan of Correction writing and implementation of system changes to allow the facilities to run in a more efficient manner for the nursing staff and other departments. I have reversed immediate jeopardy and substandard deficient surveys in the time allotted by State and Federal agencies. Turning crisis facilities into a stable and sustaining clinical operation is my greatest goal and success.

I have worked as an RN Consultant for different corporations, facilities and in different states, including Oregon, California, Washington, Nevada, Idaho and South Dakota. I have assisted several facilities to become Deficiency Free or Nursing Deficiency Free. My goals are to identify systems that are ineffective and work with management to implement successful policies and procedures to improve resident care.

Major areas of expertise and success include physical and chemical restraint reduction programs, pain management, pressure sore reduction, implementation of CQI Programs and the implementation of a Problem Identification to Resolution Model of Assessment system titled “RN Care Management” utilizing the RAI process as its’ assessment foundation. RN Consulting activities also include Interim DNS, Medical Record review, writing and implementing Facility Policies and Procedures based on acceptable standards of practice and continuing education on clinical issues for facility staff members.

In addition I have assisted facilities to meet survey goals. My philosophy is that the facility should always be doing the right thing on a daily basis so survey should be a time to shine instead of being stressful and upsetting and not in order. Survey preparation includes Investigative Protocols for Pressure Ulcers, Weight Loss, Abuse, Restraints, Dining, and Enteral Nutrition. In addition I complete a full facility survey for other departments with recommendations for improvement.

I have been successful in researching and writing opinions for facilities to dispute and reduce or discard level “G” survey findings by use of the “IDR” process. Other activities have included investigation of resident and staff incidents, potential abuse situations, and making RN determinations if abuse actually occurred as per state and federal regulations.

I have been able to utilize my earlier nursing experiences in the long term care Pharmacy venue, Emergency Room and training and education of CNAs from 1968-1985 throughout my long term care work as well.
Presented training on the topic “Legal Implications of Charting” for facility nursing staff.

Best Practices for the Long Term Community
1993-To the Present Private RN Consulting for Long Term Care Facilities

RN Consultant responsible for clinical services bringing facilities into State and Federal compliance on substandard surveys.  An immediate Plan of Correction of nursing system changes, including the RN Care Managers, RAI process, restraint reduction programs, new incontinence guidelines, and new pressure ulcer guideline programs are some successes. The facilities usually are resurveyed within 30 days are found to be in substantial compliance.  Facilities, through their Quality Improvement Program, identify and monitor all clinical indicators.  The indicators fall within normal upper and lower control patterns when the new systems are implemented.

Lumetra Private RN Contract for Lumetra, the Medicare Quality Improvement Organization for California
January-April 2007-Present

Sycamore Asset Management, Inc.

State of California Receiver and Temporary Manager 2002-Present

• Member of State of California Receiver Team Redding and Anderson, CA 2006
• Member of State of California Receiver Team Huntington and Fontana, CA 2006
• Member of State of California Temporary Manager Team Inglewood and Compton, CA 2006
• Member of State of California Temporary Manager Team at Capitola, CA 2005
• Member of CMS Temporary Manager Team at Napa, CA 2004
• Member of State of California Receiver Team at PEI, Oakland, CA 2003-2004
• Member of State of California Receiver Team at Burlingame Healthcare Center, Burlingame, CA 2002-2003.
  
  Responsible for the overall clinical operations of crisis long term care facilities when under the management of Sycamore Asset Management Inc. for the State of California. Facilities are under Temporary Management or Receivership due to bankruptcy or failure to comply with State and Federal regulations regarding long term care facilities.  Facilities have been returned to compliance on immediate jeopardy, “G” level substandard surveys and multiple complaint surveys with new system implementation. Those facilities determined by the State of California to be unsustainable are slated for closure and the residents relocated.
  

Contracted interim Director of Nursing Services Oregon, California and Nevada 1993-2004

Pharmacy Corporation of America 1987-1992
Professional Services Consultant for Long Term Care Facilities responsible for providing training and support for long term care facilities in the area of medications, medication administration, enteral nutrition, intravenous therapy. Work included audits, training, seminars, central and peripheral IV policies and procedures.