After working as a nurse for over 25 years, and never believing I would ever

have to do anything else except retire, I found myself being forced to retire from
bedside nursing due to a car accident that left me unable to stand for any long
periods of time. Therefore, I had to sit down and face reality and decide where I
wanted to go with the remainder of my life. I loved caring for and taking care of
people and I consider myself extremely great at it. I knew I wanted to somehow
work in the healthcare field but in what capacity, I did not know. I then
remembered when I started my education to get my nursing license, we had to
take a Re-Orientation to school class as a prerequisite. This was a private school
and all the students were Certified Nursing Assistants. I remember the Director of
the program said that there were 90 students between the two classes and only
30 would be able to continue on with that school for the clinical rotation of the
nursing program. We were all frantic. She then explained that over half of the
class would either fail or drop out during prerequisites. We did not believe her.
After a 6 month strict prerequisite program, we barely made 30 people. 15
people in each (2) clinical rotations at two of the cities hospitals. Enough babel
but she also told us to write down what our ambition/dream is. Was this just a
stepping stone to something greater or was being in the nursing field enough. I
still have the paper I wrote my answer down on. We all shared and I stated I
wanted to go on to become a Nursing and Rehabilitation Center Administrator.
Beneath that, I wrote, I WANT TO MAKE A POSITIVE DIFFERENCE IN EVERYONES
LIFE, MY PATIENTS AND THEIR FAMILIES, MY EMPLOYEE’S, THE VENDORS, and
PHYSICIANS AND THEIR STAFF. I put that in caps because that is how I wrote it on
the paper.
As an Administrator, I would have to at least have a basic understanding of
accounting practices and procedures as well as whether the practice was done
the way it should have been done. Besides knowing some basic accounting
procedures, I would need to know how the collecting of patients co-pay is done
and documented and would need to know to whom the different responsibilities
are assigned to. I would have to know the process and procedures for
determining patient eligibility, and ways to word things that make a person
eligible. I would also have to make sure coding is conducted accurately so
reimbursements from State (medi-caid/medi-cal) and Federal (medi-care)
Governments as well as private/public insurance companies will have to
reimburse us without delays. Actually, I worked as the MDS Nurse for a while and
it was my job to file the appropriate state and federal forms (Minimum Data Sets,
MDS). I will have to know how to keep track of claims, process for collecting all
payments and be able to follow through with the different companies on denied
claims. I have to be sure that insurance companies or whoever is responsible for
paying the bill pays it. I mention insurance specifically because most
monies/revenue come from insurance companies. If we don’t get that revenue
in, we won’t be able to pay the facilities own bills, meet payroll which in turn will
force us to close our doors.
I will also need to be sure that the staff I hire, or is currently doing the job
when I started, is properly trained in proper accounting procedures. If coding is
done inaccurately, or inaccurate data is entered, or a staff member fails to
perform a certain task in the Revenue Cycle Optimization, it affects the facility
negatively.
Like a physician, if he makes a mistake, it could be extremely costly financial
as well as possibly someone’s life. Administrators can’t assume everyone is doing
their job. To possibly prevent this problem, good communication needs to exist.
Regular meetings need to take place between the administrator and the business
office staff to help insure accuracy.