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17210 RUSSET STREET
SAN DIEGO, CALIFORNIA 92127
PHONE 858-592-6799   FAX 858-592-6800
E-MAIL RRS2000@AOL.COM

Selected Accomplishments
  • Independent nurse consultant providing Skilled Nursing Facility (SNF) expert witness, survey and certification, PPS reimbursement, quality monitoring, and corporate compliance consulting and training services to facilities, corporations, government agencies, and attorneys nationwide.
  • Founding Chair, the American Association of Nurse Assessment Coordinators.
  • Consultant to Centers for Medicare & Medicaid Services (CMS) Minimum Data Set data accuracy projects.
  • Presenter and script writer for CMS MDS-related satellite broadcasts/webcasts.
  • Expert consultant to Lumetra, California’s Quality Improvement Organization.
  • Member of the national Public Advisory Council for the Quality Improvement Organizations.
  • Invited to testify before the HHS Secretary’s Advisory Committee on Regulatory Reform, 2002.
  • Author, ”MDS Self-Audit: A Practical Guide to Ensuring Minimum Data Set Accuracy,” “Nursing Facility Enhanced Quality Measures: Strategies for Successful Performance, “ “MDS 2.0 Coding for OBRA and PPS,” “Care Planning and the MDS 2.0,” and “Billing and the MDS 2.0 for Clinicians.”
  • National seminar trainer, nursing home assessment, care, and payment systems, including OBRA, PPS, billing for clinicians; working the RAPs, care planning, nursing home Quality Measures.
  • 14 successful years as a Director of Nursing Services in the skilled nursing environment.
  • Developed, implemented, and managed a successful, 20-bed Medicaid-certified ventilator unit. After five years, managed the expansion, relocation, and certification of the new unit.
  • Redesigned nursing care delivery model for two SNFs to achieve improvements in quality of care, internal and external customer satisfaction, and financial goals.
  • Designed and implemented fall risk management and restraint reduction policies and procedures that resulted in deficiency-free surveys for these areas.
  • Developed charting systems specific to SNFs, including flowsheet assessment forms, psychotropic drug monitoring systems, and interdisciplinary care plans.
  • Created and implemented a Pain Management Protocol consistent with JCAHO and OBRA standards and which subsequently was published in “Consultant Pharmacist” journal.
  • Successfully managed multimillion-dollar budgets to meet organizational goals while providing high quality resident care.
  • Designed and implemented dynamic and effective Quality Improvement Committees, including Process Action Teams that make decisions at the level of care delivery.
  • Designed, developed, and implemented Skilled Nursing Facility Prospective Payment System systems, from initial training through post-implementation auditing, to ensure quality, cost-effective, appropriate care delivery and reimbursement.
  • Licensed by the California Board of Registered Nursing to provide continuing education to nurses.
Nursing Consulting Services
President, RRS Healthcare Consulting Services, providing SNF consulting and training services to facilities, corporations, government agencies, and attorneys nationwide.
  • Regulatory compliance and survey readiness for individual facilities and SNF chains
  • Corporate Compliance
  • MDS and PPS reimbursement and clinical processes
  • Nationwide seminars
Executive Editor and Subject Matter Expert, American Association of Nurse Assessment Coordinators

Expert witness and legal nurse consultant, plaintiff and defense, since 1996

Columnist, “Advance for Providers of Post-Acute Care” and “Contemporary Long Term Care”

Editorial Advisory Board Member “PPS Alert“ Newsletter

GROSSMONT HOSPITAL, La Mesa, CA.
General acute care hospital

Manager, Transitional Care Unit, June 1998 to February 2000
30-bed hospital-based Skilled Nursing Unit with short-term rehabilitation and medically-complex patient population.

Significantly improved the quality of care, resulting in substantial compliance surveys and elimination of citations. Provided education, training, and implementation of PPS; developed and implemented SNF policies and procedures; developed rehab nursing and case management programs. Corporate compliance trainer. Project Manager for clinical software search and implementation.

Manager, Grossmont Rehabilitation Center Nursing, August 1999 to February 2000
30-bed acute, long-term rehab unit.
Implemented redesigned, streamlined assessment and documentation systems; prepared for successful CARF and JCAHO surveys.

LIFE CARE CENTER OF VISTA, Vista, CA
164-bed skilled nursing facility
Inhouse Consultant, Director of Nursing Services, October 1997 to May 1998
Provided leadership, training, and mentoring to significantly reduce nosocomial pressure sores, absenteeism, and resident and family complaints and to improve compliance with OBRA standards; established effective Quality Improvement Committee resulting in care planning, care delivery, and documentation which met the standard of care. Program development; management of Case Management and Hospice programs and Clinical Information Systems; preparation for PPS.

PALOMAR CONTINUING CARE CENTER, Escondido, CA, September 1992 to October 1997
96-bed hospital-based SNF, including 20 subacute respiratory care beds and 28 subacute rehab beds
Director of Nursing Services and Assistant Administrator
Developed subacute ventilator unit, quality improvement, and utilization management programs. Improved quality of care while maintaining productivity and financial performance. Project Manager for clinical software search and implementation. Developed and implemented Case Manager position.

FHP HEALTHCARE, San Diego, CA, February 1992 to September 1992
Health Maintenance Organization
Skilled Nursing Facility Coordinator
Conducted utilization review and clinical case management for 13 contracted facilities. Provided education, training, and mentoring to facilitate adjustment to the HMO concept and reality.

STANFORD COURT NURSING CENTER, Santee, CA, January 1989 to February 1992
105-bed Skilled Nursing Facility
Director of Nursing Services

CAREWEST NURSING FACILITIES, Escondido and El Cajon, CA, July 1986 to January 1989
160-bed and 74-bed Skilled Nursing Facilities
Director of Nursing Services

GROSSMONT DISTRICT HOSPITAL, La Mesa, CA
41-bed orthopedics/neurosurgery unit in a general acute care hospital
Senior Staff Nurse and Relief Shift Supervisor, July 1982 to July 1986.

Education
Masters Degree in Healthcare Administration
Seton Hall University, S. Orange, N.J.

MBA Program coursework
National University, San Diego, CA

A.S. in Nursing
Grossmont College, El Cajon, CA

B.A. in Journalism
The Pennsylvania State University, University Park, PA

Selected Publications
Atchinson, D.P., Turrieta, D., & Shephard, R.R. (2001). Accurately assessing for incontinence for the MDS 2.0. Denver: American Association of Nurse Assessment Coordinators.

Shephard, R.R. (2000). Managing pain to improve residents’ quality of life. Consultant Pharmacist, 15(3), 361-362.

Shephard, R.R. (2001). Care planning and the MDS 2.0. Denver: American Association of Nurse Assessment Coordinators.

Shephard, R.R. (2001). Billing and the MDS 2.0 for clinicians. Denver: American Association of Nurse Assessment Coordinators.

Shephard, R.R. (2002). MDS 2.0 Coding for OBRA and PPS. Denver: American Association of Nurse Assessment Coordinators.

Shephard, R.R. (2003). Guest editorial: Why the nursing director is key to survival. Nursing Homes Long Term Management, 52(11), 6-7.

Shephard, R.R. (2004). Nursing facility enhanced quality measures: Strategies for successful performance. (2nd Ed.) Miamisburg, OH: Med-Pass/Heaton.

Shephard, R.R. (2005). MDS self-audit: A practical guide to ensuring Minimum Data Set accuracy. Marblehead, MA: HCPro.

Shephard, R.R. (2005). Power of protocols. Advance for Providers of Post-Acute Care, January/February 2005, p. 11-12.

Selected National Training Presentations
Billing and the MDS 2.0 for Clinicians
Care Planning and the MDS 2.0
Demystifying the Quality Measures
Corporate Compliance: Avoiding Medicare Fraud and Abuse from the MDS to Holiday Gifts
Mastering Critical Thinking Skills
Minimum Data Set Basics Course
The MDS – A Roadmap to Accuracy
OBRA Timing and Scheduling for the MDS 2.0
PPS Timing and Scheduling for the MDS 2.0
Resident Assessment Protocols and the MDS 2.0
Managing the Medicare Maze
Delirium: Unlocking the Mystery
Functional Decline: Preventing the Downward Spiral (and the Survey Deficiencies)
Shifting Organizational Culture: Strategies to Improve Resident Outcomes

Professional Affiliations
American Association of Nurse Assessment Coordinators (Founding Chair)
American Association of Legal Nurse Consultants
National Association of Directors of Nursing Administration/Long Term Care: Academy of Fellows
Health Care Compliance Association
Association of Rehabilitation Nurses
Council of Long Term Care Nurses
California Association of Health Facilities
Past Advisory Board member, Maric College, San Diego, CA