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EDUCATION
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 1993 To the Present.
Private RN Contract 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.
- 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 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.
CONTRACTED CLINICAL EXPERIENCES
Best Practices for the Long Term Care Community 1993 to the present. Private RN Contract Consulting for Long Term Care Facilities.
- Lumetra Private RN Contract for Lumetra, the Medicare Quality Improvement Organization for California January-April 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.
- 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 Measures/Quality Indicator reports. Facilities were successful in actual reduction of restraints with the implementation of a restraint reduction program at the end of the training session. 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.
- Presenter on the topic of the proper use of the federally mandated RAI,, RN Care Management and the Problem Identification to Resolution model.
Kern Valley Healthcare District Hospital and Skilled Nursing Unit at Lake Isabella, CA May 2007 to the present.
- 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 to restructure the unit from a hospital medical type unit to an actual SNF meeting the State and Federal regulations for skilled facilities. The facility passed its’ re-survey with no deficiencies.
Sycamore Asset Management, Inc. State of California Receiver and Temporary Manager, 2002-Present
- 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 have been safely discharged and relocated according to the plan. Final date of closure is April 7, 2006.
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.
Sycamore RN Consultant at Millbrae, CA 2005 to the present
- RN Consultant responsible for clinical services bringing this 115 bed facility into State and Federal compliance on annual substandard survey. 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. There have been no complaints to the Ombudsman office and no complaint surveys since the resurvey. The facility is now restraint free. The facility follows the new pressure ulcer guidelines and program implemented and is within normal parameters of in house developed pressure ulcers. The facility, through its’ Quality Improvement Program, has identified all major indicators are now within normal upper and lower control patterns since the new systems have been implemented. RN Consultant support continues at this facility.
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.
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 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 1993-2004
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.
PROFESSIONAL ACTIVITIES
- Best Practices in Long Term Care web site www.BestPracticesinLTC.com.
- 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 2004-2008.
- Speaker for California Association of Healthcare 2008, 2007 Topics include Pressure Ulcer Prevention, Accident Supervision new federal regulations, Restraint Reduction Member, American Medical Directors Association 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
Elaine C. Griswold RN BSN
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