Certified Hospice and Palliative Care Nurse
2000
View My VisualCV Online: http://www.visualcv.com/carolrn2
Contact Information
|
Carol Anderson
Carol Anderson, RN, BSN, CHPN |
|
|
|
|
||
|
|||
Certifications
Work History
Washington, DC, United States
Jul 2008 - Present
Site Visitor
As a CHAP site visitor I travel the United States to visit Home Health and Hospice agencies to confirm compliance with accreditation standards.
San Jose, CA, United States
Apr - Present
Home Health Solution Specialist
Kanrad Technologies is developing software applications for the home health and hospice industries. My role as the Home Health Specialist is assistance in Quality Assurance and ensuring that the software meets not only industry standards bur assists agencies in regulatory compliance as well.
United States
Jul 2009 - Jul 2011
Partner
Carol joined with Laura Tuttle, RN, BSN, MBA, CLNC in founding Anderson & Tuttle, LLC. The company was created to offer a menu of consulting services as well as develop research studies that demonstrate the relationship between utilization of technology and clinical and financial outcomes.
United States
May 2008 - Jul 2009
Associate Consultant
Associate Consultants participate in a variety of consulting projects. Hospice ADR processing, eligibility audits, quarterly compliance audits as well as onsite activities such as Due Diligence audits and Independent Quality Confirmation.
Richmond, VA, United States
Apr 2005 - May 2008
Regional Administrator
Regional Administrator providing direction and oversight to 4 Home Health agencies and 4 Hospice agencies in the Commonwealth of Virginia to include Richmond, Chesapeake, Fredericksburg, and Manassas, VA
Instrumental in developing strategic plans with branch adminstrators and clinical directors to identify strengths, weaknesses, and opportunities. I provided tools and assistance in implementing strategic interventions Developed indicators to monitor the progress of quality assessment and performance improvement.
Developed toolkit for company to assist in transition of Medicare Conditions of Participation to include development of QAPI program. Identified data elements and methods of retreival and analysis.
Richmond, VA, United States
Aug 2003 - Oct 2004
Software Implementation Team
Started as PRN hospice case manager upon relocating to Richmond. Bon Secours embarked on a recent implementaiton of a new back-office hospice and home health software application (McKesson). Given my experience in implementing a similar application, I was selected to represent the hospice department on the implementation team.
Bon Secours was also persuing accreditation from the Joint Commission and I enjoyed participating in developing the language for the Information Management portions of Policy and Procedure.
I performed process assessments of every component of hospice operations, translated current paper processes to electronic processes, including manuals and memos and training sessions.
Jacksonville, FL, United States
Apr 2002 - Apr 2003
Patient Care Administrator
Hired to start-up a hospice program in Jacksonville, FL as a branch of then-named Hospice of North Central Florida (they have changed their name to Haven Hospice since my employment). Florida is a "Certificate of Need" state and even though Jacksonville's population could support many competitors, only one provider had been present in that location for many years. The result was a real opportunity to educate the community at large and the medical community to the Medicare Hospice Benefit. I impllemented several educational campaigns for physicians, oncologists, facility staff, as well as new hospice staff as census grew.
Escondido, CA, United States
Apr 2001 - Apr 2002
Team Manager/Clinical Information Coordinator
I started at The Elizabeth Hospice as a Case Manager, I was promoted to Team Manager and managed a census of 60-75 patients. The Elizabeth Hospice decided to implement a new software application (Misys). I worked to beta-test the software while managing my team, then managed the implementation exclusively as point of care "field devices" were rolled out. It was at this point that my family needed to relocate and I was thankful that my new position at Hospice of North Central Florida included continuing my work with Misys software implementation.
San Diego, CA, United States
Apr 2000 - Apr 2001
Case Manager
Vitas was my first exposure to hospice and I feel fortunate to have had the experience and excellent orientation provided by the company and the mentorship from my team mates. Having experienced hospice in a positive, organized, patient-outcome-driven model has influenced every aspect of my continued career in hospice.
Home Health Experience
Sep 1992 - Apr 2000
see attached resume' at right
Served as Administrator of 4 Home Health agencies with Medical Services of America (above).
Other managerial and clinical home health experience detailed in printer-friendly resume on right.
see printer friendly resume on left for complete resume to include home health, emergency room, and pediatric work history
Education
Nov 2010 - Dec 2011
Master's in Nursing, Family Nurse Practitioner
Clincal Leader Program, Hospice
Program Description: "In all my years, I have seen few clinical managers receive the training needed to be effective on the BUSINESS side of hospice. This is a lost opportunity as these managers have dramatic power over costs, perhaps more than any other position. In my career, I have referred to the ones that have mastered the business side…these special clinical leaders…as “Golden” as they successfully balance the ideas of profit and purpose. This program will be a “shock” to many participants, but that is exactly what is needed. If our hospices aren’t absolutely thriving economically with the current great Medicare reimbursement, something is wrong…and the Clinical Leader plays a HUGE role." Andrew Reed, CPA
Hospice Regulatory Bootcamp, Hospice
Program Desription: This intensive and innovative educational program is designed to provide participants with state-of-the-art knowledge, understanding and resources related to hospice regulations.
2001
International Honors Society of Nurses
San Diego, CA, United States
1998 - 2000
BSN, Nursing
Member of Sigm Theta Tau
Internation Honor Society for Nurses
Lake City, FL, United States
1987 - 1992
ASN, Nursing
Lake City Community College enjoyed a 100% pass rate for many years.
Skills
ADR Appeals and Processing
(Rockstar)5-6 Years Experience, (Currently in use)
Home Health and Hospice agencies get ADR's (Additional Development Requests) from their RHHI (Regional Home Health Intermediary). I have successfully appealed ADR's for all RHHI's (National Government Services, Cahaba, and Palmetto) for both home health and hospice claims.
Answering ADRs is one of those skillsets that are not used very often in the normal home health or hospice manager's career. ADR's that are denied lead to more ADR's until an acceptable percentage of questioned claims are paid.
For small agencies, it can take months to reach that "acceptable percentage" just due to the sample size. This can result in a rapid reduction in cash flow.
ADR decisions can be appealed through 4 more levels. However, it can take over a year to exhaust all appeals efforts. Meanwhile, any subsequent claim is held and the number of claims being requested grows, resulting in an agency literally swamped with ADR's.
It pays to address any additional development request immediately and professionally to ensure continued cash flow.
Survey Plan of Corrections
(Rockstar)3-4 Years Experience, (Currently in use)
I have written successful plans of correction for state, Medicare, Joint Commision, and CHAP surveys. One of the most important elements in the plan of correction is the monitoring plan. The monitoring plan is difficult to enforce and requires precision management and sheer determination to commit to it.
If your plan of correction calls for a 100% review of all records monthly, be prepared to demonstrate that you have accomplished it. If you know that is unrealistic, then revise your plan of corrections to plan for a more focused audit depending on the G tag, L tag, deficiency, or required action.
Strategic Planning
(Rockstar)3-4 Years Experience, (Currently in use)
Strategic Planning is a road map. I work with agencies to develop strategic plans from start up agencies that are in the first stages of figuring out what resources will be needed to get through the licensure and start up phase through adding new business lines, new programs, marketing campaigns, staffing models, implementing software solutions and adding more branches, etc.
Strategic planning should be done every year at a minimum. Its not just for your accrediting body. Ideally, it should be a living document that is consulted and revised often. It's a map; and to use a map you have to determine where you are, where you are going and what resources you will need to get there.
Hospice Software Implementation
(Advanced)10+ Years Experience, (Currently in use)
Hospice software solutions are a little more difficult to select and implement than home health software solutions. I have implemented and observed several solutions. Some work great, some create more problems than solutions.
Clinical Management
(Expert)5-6 Years Experience, (Last Used <1 year ago)
Clinical Management is one of the hardest jobs in the industry. It requires a wealth of clinical knowledge in the industry. Clinical Management in a hospital or facility setting does not necessarily translate to community based programs.
The Clinical Manager position makes decisions that can impact up to 60% of agency revenues: from whether or not to admit, whether or not to recert, how many visits, resources to apply to the episode, etc. In hospice, the determination of the terminal diagnosis has impact on expenses as the hospice is required to pay for meds and supplies associated with the terminal diagnosis.
Clinical Management is more than scheduling and putting out fires. It's planning, strategy, education, and oversight.
QAPI Implementation
(Rockstar)3-4 Years Experience, (Currently in use)
Extensive training in the new Medicare Conditions of Paraticipation and assessing, analyzing, and implementing mandated Quality Assessment Performance Programs and Performance Improvement Projects
Home Health Operations
(Rockstar)7-9 Years Experience, (Currently in use)
Demonstrated Understanding of Prospective Payment Reform and Medicare Conditions of Participation. Well versed in Joint Commission Standards as well as CHAP standards of excellence. Current employment as CHAP surveyor has been the best experience in my career of observing what works and what doesn't in home health and hospice.
Home Health/Hospice Start Up
(Rockstar)10+ Years Experience, (Currently in use)
Demonstrated experience and understanding of state application and licensure processes as well as Medicare Certification processes. Budget building, strategic planning, developing policies/procedures, forms, orientation programs for both Clinical and Financial components of the Home Health and Hospice industries.
Hospice Advocate
(Rockstar)10+ Years Experience, (Last Used <1 year ago)
Visual CV Contest Winner!!
Interview with Home Health Line about ADR's
I was interviewed by Karen Long at Decision Health about appealing ADR's. It starts on page 3 and continues on page 5.
References
Elias Demoz, MD, MBA
(Professional)
Board Certified Hospice and Palliative Care Physician
New Era Physicians
804.218.2094
“Carol is an indispensible partner for all professionals involved in end of life care issues in the community. She has phenomenal administrative & organizational skills, sound clinical knowledge, and demonstrates exceptional skills of communication, presentations and training staff. She is indeed, an invaluable asset to Medi hospice and to the community at large. I am privileged to work with Carol towards excellence in Hospice and palliative medicine.” Dr Elias Demoz
James Chin
(Superior)
Corporate Director
Medical Services of America
800-845-5850
"...To summarize my impression of Carol, I personally find her character to be ethical, resourceful, and passionate. I have learned much from Carol regarding the Hospice business, and what I found to her credit, is her passion in providing quality Hospice Services." James Chin, MHA
Autumn Spence
(Professional)
National Director of Business Development
Outcome Resources
“I have worked with Carol on an array of issues in regards to healthcare and hospice. She has displayed a passion for the industry, the ability to move quickly in times of change and with grace in challenging situations. She is a natural leader that has shown great awareness to details but clear overall vision. Carol is committed to achieving excellence for herself, her team and her employer. She is a charismatic, smart, professional asset to any organization." A. Spence
Barbara Flyr, RN, BSN
(Subordinate)
Home Health and Hospice Administrator
Medi Home Health and Hospice
757.420.7192
"Carol Anderson is a knowledgeable, fair and consistent manager. She brings a wealth of information, skill and inspiration to the teams she works with. Her presentations are awesome. They are done in such a manner that those with knowledge and those who have none come away having learned from the information presented. Her nursing skills are excellent as a clinician she shows a caring and generous spirit for her patients and the families that she is involved with. It has been a pleasure working with Carol, I have learned a great deal from her about Hospice, Management and providing Education to peers."
Barb Flyr, RN BSN
Susan Hogg
(Professional)
Executive Director
Virginia Association for Hospices
804-467-2626
"Carol has a keen understanding of regulations, understands their intent and is very adept at educating staff regarding compliance.
Carol is an excellent leader. She is motivational and participatory." Susan Hogg
Tara Stewart RN, BSN
(Peer)
Corporate Marketing Director of Home Health Care and Hospice
Medical Services of America
800-845-5850
“Carol's knowledge of the Hospice arena is bar none to those around her. With the recent changes in Hospice, Carol is one of the few people I trust with the the up to date information needed to stay abreast and maintain excellence in the field. Not many folks can hold a candle to the depth of knowledge she possesses, nor can walk a mile in her shoes. Carol's leadership is strong, even when the storms come, her sun begins to shine!” Tara Stewart, RN, BSN
Kenneth Fracaro
(Other)
Author
"Carol Anderson is what we consider in the management field an intelligent and high performer. She gravitates toward and has passion for challenging tasks and projects she undertakes. In addition, she willingly takes on responsibility and initiative to maximize her job performance. It is quite apparent that she is a person who gives one the distinct impression that with Carol, anything is possible and it will lead to a successful conclusion." Ken Fracaro
Kenneth Fracaro writes and edits trade articles and online courses and I have enjoyed collaborating and benefitting from his talents for over 15 years.
Sales Presentation
Management Presentation
Clinical Presentation
Marketing Presentation
Creative Writing Sample
Tool for Understanding Proposed COPs
Business Plan
This VisualCV is available as a printable .pdf file