Deborah Unger, RN,

154 Lake Chateau Drive Hermitage, TN. 37076-3007

Home Phone #615-871-4985 Cell: #424-3985
du83f10a@westpost.net
_____________________________________________________________________________
QUALIFICATIONS
Recognition through The National Association of Healthcare Quality (NAHQ) As a
Certified Professional in Healthcare Quality (CPHQ) 1995 - 2004
Certified as a Long Term Care Surveyor through Centers for Medicare and Medicaid
(CMS) in 2002.
* Upper management and consulting levels in homecare environments. Experience w
ith JCAHO, Federal Conditions of Participation (COPs), State, and Centers for Me
dicare and Medicaid Services (CMS) guidelines.
* Experience with Medicare denials, case management, audit skills, utilization
review, telephonic concurrent review.
* Proficient in Microsoft Word, Excel and PowerPoint computer skills
WORK HISTORY
Gentiva HomeCare (5/1/2010 to present) Staff - RN for home health care compa
ny. Skilled nursing care of patients in their home environment; including geri
atrics , orthopedics, and internal medicine population. Inter- disciplinary t
eam approach, case conferences. Notification to physician of changes in pati
ent status. Completion of OASIS regulatory documentation.
Guardian Hospice - Quality Improvement Director (10/08 to 9-09) . Implementa
tion of new Hospice Federal Conditions of Participation, staff development,. Ben
chmarking against national Hospice guidelines Zero deficiencies on State Survey
.
NHC Homecare Regional Administrator / Director of Performance Improvement (11
/03 10/08) Regional Operations manager of 7 homecare agencies. Internal audits
in Performance Improvement, OASIS and ICD-9 CM Coding in preparation of Pay 4 P
erformance. Zero State Survey deficiencies. State Travel.
Blue Cross Blue Shield (4/03 11/03) TennCare Case Manager Perform telep
honic case management with adult and pediatric patients. Utilization review,
care planning, Authorization of referrals to hospitals, home care, private duty.
Review records in accordance with company policies. Process denials, refer to
Medical Director. NCQA Accreditation
Tennessee Department of Health /Division of Health Care Facilities (6/02 11/03
) State Surveyor - Long Term Care - Investigation of consumer complaints ag
ainst healthcare facilities. Inspection and interpretation of State and Federal
guidelines r/t healthcare facilities.
Healthcare Consultants, Inc (5/00 - 6/02). Clinical Consultant / Medicare Appea
ls Analyst
Worked under Melinda Gaboury for analysis and preparation of appeal process for
Medicare denials via contract with a national rehabilitation company. HIPPA, Cor
porate Compliance
HomeCare Solutions, Inc. (7/99 5/00) Director of Clinical Services Opera
tions, Performance Improvement and clinical oversight of three merged companies,
(Home Health. Hospice and DME) consisting of 7 offices, covering 30 counties. S
uccessful State and JCAHO accreditation.
America Service Group, Prison Health Services - (4/99 - 6/99) Interim Risk Manag
er - Review/analysis of multi-state prison site incident reports.
Identification and analysis of loss exposures for company. Interact with regulat
ory agencies, insurance and law firms.
 Friendship Healthcare Services Consultant - (2/99 4/99) Planning and implem
entation of Corporate Compliance Plan, QI, Advisory Board, and annual program ev
aluation.
Quality Healthcare Management Columbia Homecare (1996 1998) Assistant Admin
istrator. Michael Minch, MD owner. Management company contract for overall
administration and operation of hospital based home health agency. JCAHO accred
itation in 1997. Columbia Home Health sold 7/98. Currently HCA/Tristar
ResCare Management Services (1994 1996) QI Specialist. Multi-state Operationa
l audits/analysis, QI compliance and regulatory training. JCAHO and Medicare p
roviders. l. Company sold 96.
ABC Home Health - (1991 1993) Staff Development Coordinator: Direct client ca
re and management. Development and facilitation of regional orientation of fiel
d employees. Company dissolved 1993.
Vanderbilt University Medical Center _ (1986 1991) Staff RN, Quality Perform
ance/Utilization Management. Concurrent and retrospective reviews for insurance
providers.
EDUCATION
* State of Tennessee Dept. of Health and Environment Board of Nursing
* #RN0000071945, exp. 10/31/2011
* Tulsa Junior College, School of Nursing, RN - AAS Degree 1980
* Tulsa Vocational School of Practical Nursing, 1974 - LPN
* .Certified Surveyor in Long Term Care 10/2002
REFERENCES
Cathy Nash, RN DON - WestMeade Pl Work: 615-352-3430, Cell: 615- 289-3051 .
cnash@WestmeadePlace.com
Madeline Coleman, JD, RN Quality Manager State of TN. Work: 615-741-7524, Ce
ll: 615-668-0937
Michelle Bobo, RN Director of homecare Regulatory and Compliance Tn Assoc. Ho
me Care -
Cell: 615-604-6656