CV for Elaine Griswold RN BSN President
Best Practices in Long Term Care, Inc.
36295 Hillside Lane ? Lebanon, Oregon 97355
work/cell: 541-990-5775 • home: 541-4708 • fax: 541-258-6423
MISSION AND PHILOSOPHY
Elaine C. Griswold RN BSN is dedicated to the concept of providing the highest quality of care and services to the long term care community across the continuum of care. The philosophy of the pursuit of excellence by using the principles of Continuous Quality Improvement (CQI), the RAI Process, RN Care Management and continuing education of staff is the foundation of my work. The last 27 years has been spent in the long term care community where I have put my principles and philosophy in action and have reaped the rewards of assisting facilities and nurses improve the quality of care to their residents. Best Practices in Long Term Care, Inc. is my consulting business of which I am President..
Bachelor of Science in Nursing, 1964-1968
Boston University School of Nursing, Boston, MA.
CLINICAL EXPERIENCES 1987-To the Present
Best Practices for the Long Term Care Community, Inc. 1993 to the present.
Private Contract Consulting for Long Term Care Facilities
• Contract with facilities under the monitoring of the Office of Inspector General (OIG) to assure compliance with the Corporate Integrity Agreement (CIA). Our consultants provided oversight and training for the facilities resulting in progress towards compliance with CIA requirements, State and Federal monitoring and regulations. The Independent Monitor, Long Term Care Institute, has reviewed and is pleased with my system implementation results wrought in a short period of time in crisis facilities. The use of the RAI process, a Problem Identification to Resolution model and RN Care Management program have improved the quality of resident care in a common sense approach that meets the intent of monitoring and sustained regulation compliance. Ability to construct successful Action Plans based on the Independent Monitor model. Excellent survey results for the facility.
• Contracted with companies and facilities to provide facilities in crisis, including substandard to immediate jeopardy (IJ), K and L level scope and severity, 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 stable and sustaining clinical operations, providing high quality of resident care is my greatest goal.
• I have worked as an RN Consultant for different corporations, facilities, and risk management companies and in different states, including Oregon, California, Arizona, 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 and self sustainable systems with effective policies and procedures to improve resident care.
• Major areas of expertise and success include physical and chemical restraint reduction programs, fall prevention 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 Director of Nursing Services (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.
• Writing and implementation of specialized policies and procedures for skilled nursing facilities; by working with the facility's accepted policies and procedures, standards of practice and programs, my specialized policies enhance their total compliance.
• Reducing unnecessary and redundant documentation and implementing simplified, user friendly forms that assure compliance with State and Federal regulations is always appreciated by the facility staff.
• Worked with risk management companies on specialized projects to reduce their clients' liability in identified problematic areas. Problems are identified and an Action Plan developed for the facility to use through their Quality Assurance program.
• I have assisted facilities to meet survey compliance 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, but is not limited to, Investigative Protocols for Pressure Ulcers, Weight Loss, Abuse, Restraints, Pain, Unnecessary Drugs, Accidents/Supervision, Dining, Dialysis, Enteral Nutrition and Medical Director. In addition I complete full facility Federal and State peer review pre-surveys for all 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 LTC 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.
Private Contract Consulting for a venture capitalist group.
• Confidential contract with a venture capitalist group requiring due diligence procedures for review of multiple facilities with identification of clinical systems and application of regulations in the provision of resident care.
Private Clinical Contract Consulting for Long Term Care Facilities
• Provision of Clinical Consultant services to long term care facilities. Our consultants include RN BSN Consultant, MDS/RAI Trainers, RN Care Managers, Administrators, and Clinical Compliance Officers for the OIG, Interim Director of Nursing, Registered Dietitian, Medical Records, Activities and Housekeeping. My consultant staff has many years of practical expertise and is current on new regulations assisting facilities to remain in sustained substantial compliance. Our implemented systems have been approved by all State and Federal surveyors as evidenced by good surveys.
Private Contract RN Consultant Sharp Coronado Hospital and Health Center 2011 to the present
• Provision of Clinical Consultant services to the Sharp Coronado Hospital and Health Center for the implementation of clinical systems that ensured compliance with State and Federal regulations for skilled nursing. The hospital is licensed for 144 skilled nursing beds of which approximately 75 beds are designated as subacute beds for those residents who require subacute services. The facility had a successful annual survey, implemented policies and procedures that discontinued restraints, reduced psychotherapeutic drugs, reduced nurse hospital type documentation and initiated a process that successfully removed residents who were colonized with Multiple Resistant Drug Organisms (MDRO) from strict isolation. Systems implemented ensured long term care regulatory compliance and reduced overall costs to the hospital.
Private Contract RN Consultant Gramercy Court, Sacramento, CA 2010 to the present
• Assisted the facility to return to substantial compliance in the area of pressure sores. The facility had been cited for a G level Scope and Severity for pressure sores. I implemented my Pressure Ulcer Prevention Program. The facility cleared the deficiency on the first revisit and has sustained compliance in that area. The RAI process of assessment by the use of Problem Identification to Resolution and RN Care Manager Models were implemented. New programs for restraint reduction, fall prevention, and pressure ulcer prevention were implemented and are working well. Excessive documentation and committee meetings to meet compliance requirements were simplified.
Private Contract RN Consultant Crestwood Behavioral Health, Inc. 2009 to the present
• Provision of Clinical Consultant services to this corporation providing long term mental health programs to 16 facilities. Assisted one facility to return to substantial compliance in the area of nutrition and weight loss. The facility had been cited for a G level Scope and Severity for nutrition. In 2009 the Clinical RD Consultant assisted the facility to return to sustained clinical compliance. The facility has undergone its' annual survey with no G level tags in nutrition and weight loss. Nutrition at Risk programs implemented continues to work well. In 2010 the corporation wanted to enhance the quality of care in one of its' facilities. The RAI process of assessment by the use of Problem Identification to Resolution and RN Care Manager Models were implemented. New programs for restraint reduction, fall prevention, and pressure ulcer prevention were implemented and are working well. Excessive documentation and committee meetings to meet compliance requirements were simplified. Good surveys continue.
Private Contract RN Consultant Meadowood Nursing Center, Clearlake, CA 2009 to the present
• Assisted the facility to undergo a complete systems change to assure compliance with State and Federal regulations. The RAI process of assessment by the use of Problem Identification to Resolution and RN Care Manager Models were implemented. Physical and chemical restraints were reduced and discontinued. CNA dementia training was implemented. Licensed staff was inserviced on new change of condition and care planning procedures. New programs for restraint reduction, fall prevention, and pressure ulcer prevention were implemented and are working well. Excessive documentation and committee meetings to meet compliance requirements were simplified. The facility staff can see the major improvements that have occurred since the changes were implemented. They are a pilot project for the use of the RN Care Management model for California Association of Healthcare Facilities. Excellent Nursing Deficiency Free survey 2009. The facility has won a national award in the overall reduction of indicators.
Private Contract RN Consultant The Rafael, San Rafael, CA. 2009 to the present
• Assisted the facility to return to compliance in the area of restraints. The facility had been cited with a level G Scope and Severity for the use of restraints. They were unable to clear the deficiency and return to compliance by the CA Department of Public Health Department (DPH) on the revisit. I assisted the facility to return to compliance in a two week period of time implementing the "I Want to be Free" Restraint Reduction Program. The comprehensive Plan of Correction was accepted by the DPH and the facility was returned to substantial compliance in restraints. The facility continues towards its' goal of being restraint free.
Private Contract RN Consultant Magnolia LTC Management Services, Santa Rosa, CA. 2009
• Contracted with the company for a Focused Fall Prevention Project to review their facilities with areas of potential liability in the area of falls. Onsite visits were made, and areas of concern were identified. Survey results, facility practices and policies and procedures were reviewed. A facility systems review was conducted. Inservice training was provided to the facilities. Reports and Action Plans to reduce falls were prepared and left with the facility and sent to the company. The company is assuring that the Action Plans and recommendations are followed by the facility.
Private Contract RN Consultant A&C Healthcare, San Jose, CA 2008 to the present
• Corporate Compliance Officer providing oversight of facility practices and compliance with Office Inspector General monitoring. 2009 to the present.
• Assisted two facilities to return to substantial compliance with the State survey and reduced the severity of the facility's crisis status with the Independent Monitor by the implementation of the use of the RAI process, the Problem Identification to Resolution model and RN Care Management program. All restraints were successfully removed and pressure ulcers reduced. The Independent Monitor was pleased with the quick turn around progress of these facilities.
Private Contract RN Consultant ISU Pinnacle Insurance Services, Inc. 2008-2009
• Assisted their identified problematic facilities to return to compliance under the OIG monitoring. The Best Practices in Long Term Care Consultant team was instrumental and successful in returning the facilities to substantial compliance in State, Federal and OIG requirements.
Private Contract RN Consultant at Millbrae Convalescent Hospital, CA 2005 to 2011.
• The facility had been under my guidance using my clinical systems since 2005. Its 2008 annual survey was nursing deficiency free, the first time in its' history. I was the RN Consultant responsible for clinical services bringing this crisis 115 bed facility into State and Federal compliance on annual substandard survey in 2005 under while under contract to Sycamore Asset Management, Inc. An immediate Plan of Correction of nursing system changes, including the RN Care Managers, RAI process, restraint reduction program and a new pressure ulcer guideline program was implemented for resurvey. The facility was resurveyed in 30 days and was found to be in substantial compliance. The facility was restraint free. The facility followed the new pressure ulcer guidelines and was within normal parameters of in house developed pressure ulcers. The facility, through its' Quality Improvement Program, had identified all major indicators which were within normal upper and lower control patterns since the new systems were implemented.
• The facility remained in long time sustained compliance using the systems implemented. The private owner made the decision to close the facility in 2011 due to the lack of reimbursement from the State of California.
Lumetra Private RN Contract for Lumetra, the Medicare Quality Improvement Organization for California 2007- 2008
• 2008 Presenter for the "Show Some Restraint" Restraint Reduction Workshop; 6 sessions sponsored by Lumetra and the Quality Care Health Foundation, the educational arm of the California Association of Healthcare Facilities (C AHF). The material used for Lumetra's California training is my program "I Want to be Free" Restraint Reduction program for long term care facilities.
• 2008 Presenter on the topic of the proper use of the federally mandated RAI, RN Care Management and the Problem Identification to Resolution model in a teleconference format.
• 2007 Presenter for the Person-Centered Care Collaborative Learning Session 6 in the area of pressure ulcer prevention in compliance with F Tag 314. Facilities learned if their pressure ulcer prevention programs met the intent of F Tag 314 and were in compliance. The program used in the pressure ulcer training is my Pressure Ulcer Prevention Program.
• 2007 Private Consultant providing intensive training and assessment in the areas of restraint reduction and pressure ulcer prevention programs in facilities identified with high usage rates for restraints and pressure ulcers, resulting in high percentages in these areas on the Quality Measure/Quality Indicator reports. Facilities were successful in actual reduction of restraints with the implementation of my restraint reduction program at the end of the training session. My written Pressure Ulcer Prevention Programs were implemented in these facilities with policies and procedures, and training in assessments and care planning. The facilities gained understanding of facility compliance with F Tag 314. Lumetra's stated goal of reducing the actual numbers of physical restraints in the State of California was reached.
Sycamore Asset Management, Inc. 2001- Present Private RN Consultant Contract
Kern Valley Healthcare District Hospital and Skilled Nursing Unit at Lake Isabella, CA, May 2007 – May, 2008.
• Clinical Services Consultant responsible for the overall clinical operations of the hospital skilled unit. This unit had a history of 3 very poor surveys from January 2007 in the area of unnecessary drugs, medication pass, physical and chemical restraints in the Scope and Severity levels of G, H, I, J, K and L. The facility was also in an immediate jeopardy situation for medication pass for a month prior to the implementation of clinical systems in May of 2007 to restructure the unit from a hospital medical type unit to an actual SNF meeting the State and Federal regulations for skilled facilities. During our oversight, the facility passed its' re-survey with no deficiencies and was subsequently removed from the CMS Focus Facility List.
Sycamore RN Consultant at Aberdeen, SD, 2004-2005
• RN Consultant responsible for bringing this 125 bed facility into State and Federal compliance on annual survey with six level H deficiencies. An immediate Plan of Correction was implemented for resurvey. The facility was resurveyed in 23 days and was found to be in substantial compliance. The State of South Dakota Department of Health survey team was pleased with the facility's implementation of RN Care Managers, the RAI process, Infection Control programs and a Quality Improvement program. The facility also returned to compliance in the areas of identification and reduction of pressure ulcers, restraints, falls and infections.
Sycamore Asset Management, Inc. State of California Receiver and Temporary Manager, 2001-2006
Member of State of California Receiver Team at Redding and Anderson, CA 2006
Member of State of California Receiver Team at Huntington and Fontana, CA 2006
Member of State of California Temporary Manager Team at Inglewood and Compton, CA 2006
• Clinical Services Consultant responsible for the overall clinical operations of these immediate jeopardy and crisis facilities providing immediate quality nursing and other clinical care to the residents and implementing clinical systems to bring the facilities into substantial compliance for resale or closure.
Member of State of California Receiver Team at Monterey, CA 2006
• Clinical Services Consultant responsible for the overall clinical operation of this 54 bed facility under the direction of the court appointed Receiver. Responsible for providing immediate quality of nursing and other clinical care for residents to this immediate crisis facility. The facility's previous Plan of Correction was rejected by the Department of Health. A new Plan of Correction was written, submitted and approved by the Department of Health, including an immediate jeopardy finding in weight loss. The Plan was implemented of nursing system changes, including the RN Care Managers, RAI process, restraint reduction program, weight loss and other identified dietary concerns. Each resident received a full comprehensive assessment by the interdisciplinary team, including an MDS, RAPs and Care Plan to accurately reflect current status. The State of California slated the facility for closure. The Sycamore Asset Management Team was responsible for the implementation and completion of the State approved Relocation Plan. Residents were safely discharged and relocated according to the plan.
Member of State of California Temporary Manager Team at Capitola, CA 2005
• Clinical Services Consultant responsible for the overall clinical operation of this 99 bed facility under the direction of the State Appointed Temporary Manager. Responsible for providing immediate staffing and nursing care to this immediate crisis facility. The facility was returned to compliance from previous substandard annual and several complaint surveys within 30 days. The State of California determined the facility to be unsustainable and it was slated for closure. The Sycamore Asset Management Team was responsible for the implementation and completion of the State approved Relocation Plan. Residents were safely discharged and relocated according to the plan. Final date of closure was January 12, 2006.
Member of CMS Temporary Manager Team at Napa, CA 2004
• Clinical Services Consultant for the overall clinical operation of this 60 bed facility.
• Responsible for bringing the facility into immediate compliance from an Immediate
• Jeopardy situation followed by the correction of an annual Substandard Survey and seven additional complaint surveys within 60 days. The quality of care improved, including the implementation of many systems, RN Care Managers and staff training. The facility was slated for closure of the facility by the State of California. Sycamore was responsible for the closure of the facility.
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.
• Clinical Services Consultant responsible for the overall clinical operation of this 281 bed facility in bankruptcy. Responsible for bringing the facility quickly into survey compliance and to provide a high quality of resident care. A good annual survey, discontinuation of physical restraints, reduction and discontinuance of chemical restraints, reduction in actual pressure ulcers and a reduction in resident/family complaints are some successes obtained. The facility was spared closure and was purchased by San Mateo County. The Receiver team maintained excellent relationships with the Department of Health Services and the Ombudsman office. The reputation of the facility improved as well. Acted as a member of the Corporate Compliance Committee.
Contracted interim Director of Nursing Services Oregon, California and Nevada 1993-2010
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.
• Author of Unnecessary Drugs F329 Facility Compliance Training Program 2009
• Author of Accidents/Supervision F323 Compliance Training Program 2008
• Author of "Pressure Ulcer Prevention Program" 2007
• Author of "I WANT TO BE FREE" a Restraint Reduction Training program. 2006
• Author of "WHAT HAS HAPPENED TO ME' A Dementia Specific Training Program specially designed for CNAs to understand Dementia and its' implications. 2002 Web site www.cnadementiatraining.com.
• Associate Member, California Association of Healthcare Facilities 2004-2012.
• Associate Member, American Medical Directors Association 2008-2012.
• Speaker for California Association of Healthcare Facilities 2009, 2008, 2007. Topics include Pressure Ulcer Prevention, new Federal regulations on Accident/Supervision and Restraint Reduction. My programs are the basis of the presentations.
• Presenter for Lumetra, conference series on the topic, "The RAI Process of Assessment…Connecting the Dots." 2008
• Writer for the primary Long Term Care Facility Closure Plan for Sycamore Asset Management, Inc. and approved by the State of California, 2002-2006.
• Member of Committee to write and approve National Intravenous Policies and Procedures for Pharmacy Corporation of America.
• Developed seminars on Enteral Nutrition and Intravenous Therapy for Pharmacy Corporation of America.
• Member of the Advisory Committee of the Linn Benton College School of Nursing 1987-1992
LICENSURE AND ACHIEVEMENTS
- I currently hold active RN licenses in the states of California and Oregon.
- Who’s Who in American Nursing 1988-1989, 1991-1992, 1994-1995, 2001-2002
- Who’s Who of American Women 2006-2007
REFERENCES AVAILABLE UPON REQUEST
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