Profiles of Case Managers

In health care, much of the attention is often focused on the doctors and nurses who provide life-saving care. But when their work is through, Rafael Almonte’s job is just beginning.

As public assistance reimbursement specialist, Rafael works with patients who cannot afford to pay for their medical bills. His clientele includes a wide range of people, including those who are without health insurance, have significant medical expenses or are unemployed.

Rafael treats each patient as a valued individual. No matter how dire a person’s needs, Rafael goes to great lengths to ensure everything is done to help them. His work takes him from the bedside of patients, where he interviews them and gathers information that determines their qualifications for assistance. Often he will transport patients in his own car for appointments with governmental agencies. He has tracked down homeless people in the woods outside of town where they live, to make sure they have filled out the proper documentation. On occasion, Rafael has purchased meals for hungry patients. All of it is done at his own expense, but for Rafael it is simply a wise investment in the people he serves.

Rafael’s diligence is beneficial for the patients, making sure they don’t fall between the cracks. But it is also helpful for the health system, a not-for-profit organization, ensuring that as much reimbursement is captured as possible. That allows Martin Memorial to remain financially viable and to continue seeing patients that have fewer resources.

For his hard work, dedication and commitment, Rafael has received a great deal of recognition from peers and the community. In December 2005, Rafael was named STAR of the Month – a monthly award given to Associates who are nominated by co-workers and selected by a committee. He was then selected STAR of the Year, a title given to the Associate who best exemplifies the mission and vision of Martin Memorial.

Finally, Rafael was named as a Pillar of Character Award winner for 2005-06 by the Martin County chapter of the United Way. Winners were judged by their demonstrated commitment to the United Way’s Six Pillars of Character: trustworthiness, respect, caring, citizenship, fairness and responsibility.

Rafael has demonstrated those traits time and again, to the benefit of countless patients.

Joanne has worked at Imperial Point Medical Center since 1982 starting out as an LPN on the Medical Surgical floor. She was promoted to an RN position in 1984, on the same floor. In 1986, she transferred to a position as an acute care case manager and has remained in the department helping the patients, their families and physicians ever since.

She is a role model for being a “Team Player” to the floor staff and the physicians. She has expanded her knowledge base over the years and is known at Imperial Point Medical Center as the “Go To” person if assistance, guidance or a recommendation about a patient discharge is needed. JoAnne has complete knowledge of available resources in the community that she can utilize to assist the patient and their family. There are numerous accolades from patients and their families which describe how her assistance has made huge differences in their health and well being. One family wrote, “Joanne was so kind and understanding and always trying to help us. She definitely put the patient first”.

JoAnne is on the floor with the highest patient turnover, yet continues to eliminate “avoidable days” and “over/under utilization issues.” Joanne is quick to jump in and assist, and worked tirelessly during the busy hurricane season last year to ensure that patients were safely discharged. During this time, she recognized the critical issue with dialysis patients due to lack of electricity at regional dialysis outpatient centers and brought it to the attention of senior administration. JoAnne has also been praised by members of the Medical Record department for her excellent progress notes, which are legible and to the point. Her skill in writing and communication is noted by physicians, and insurance companies. JoAnne takes pride in having the least amount of denials in the department and is eager to enter into lengthy discussions on behalf of the patient to ensure that they are not released and discharged before they are ready. For all-around case management expertise and professionalism, JoAnne is clearly one of the leaders in the field!

While Regina always knew that she wanted to go into nursing, she knew that she found a niche she loved when she saw how she could help patients and their families in the capacity as a case manager. Regina has been with Imperial Point Medical Center in Fort Lauderdale for three years as an acute care case manager. She initially worked exclusively on the Infectious Disease floor, but quickly learned Intensive Care Unit, Telemetry and Critical Care patient floors and their special discharge needs. Before that she worked as a home health nurse in the local area.

Gina has an active family life and has learned how to juggle many needs and keep things on an even keel. She has been married to her husband Tim for 15 years and has three children, a dog, hamster, rabbit, and a gecko. This active family unit has prepared Gina for the multitasking which is inherent with being a case manager. On the floors, Gina has been recognized by her peers as a leader and a resource for unusual and challenging discharge cases. Regina’s calm and pleasant demeanor allows the patient, family members and medical staff to work together to find the optimal discharge plan for the patient. She recently obtained the assistance of the Mexican Embassy to aid in sending a member of their armed forces back to their local regional hospital, which was the wish of the patient’s elderly mother. Regina took care of the patient and the mother, ensuring that they got to the air ambulance and negotiating the bill to ensure that the family would not be charged.

Gina is well respected by the Medical Staff as to her skills and effective management of the patient’s inpatient stay as well as their discharge plan. Some physicians will ask her “What do you recommend, Dr. Fyke?” Regina demonstrates strong leadership skills and was recently promoted to the coordinator position based on her continual contribution to the patients and to the staff. She is enrolled in the North Broward Hospital District’s Leadership Academy, which provides classes to further develop management skills in those who may be the future leaders of the district. She is an active supporter of the Juvenile Diabetes Foundation and works tirelessly for this cause.

Sophia Campbell, MSW, has been with North Broward Medical Center the last year and a half, and she has already made a lasting impact on her colleagues and her patients. She is an example of an exceptional case management team member for many reasons.

First and foremost, Sophia is a wealth of knowledge of resources in the community. Just one example of this was on a recent case where Sophia located a special needs shelter with access to medical care on an ongoing basis for a homeless patient who had no family and no means to pay for housing or care. In addition, the patient also presented with a great many psychiatric issues and Sophia was able to build a rapport with the patient and to help her feel comfortable with the plan.

Sophia always offers to help orient new staff, assisting them with their understanding of processes, resources, and ways to make the job go as smoothly as possible. In the last several months, three new social workers have joined the department and on or before their first day, Sophia has volunteered to be their mentor. Each one of them has spoken highly of Sophia’s guidance, mentoring and friendship.

Sophia’s ability to handle stressful and chaotic situations with composure, grace, and efficiency is to be praised. We all know how hectic case management can be and Sophia makes it look so easy! Sophia is truly a leader in the case management department at North Broward Medical Center and we are all lucky to have her as part of the team.

Sophia Catabay, R.N., has been at North Broward Medical Center for five years as an acute care case manager. She is acknowledged as an example of an exceptional case management team member for her quality performance, team work and a variety of initiatives that are above and beyond her job description and performance expectations.

Sophia received the Excellence Award for her participation in the design, creation and presentation of the showcase storyboard for Quality Expo on “The Amazing Race”. This storyboard also won the Superior Teamwork Award at the state competition. She assisted in the completion of the Franklin Award application. This was the first time for the department to participate in this prestigious award.

Her work on her assigned floor also deserves mention. She is a mentor to new employees in the case management department and has mentored RN case managers as well as MSW social workers. Her dedication to the sixth floor is instrumental in maintaining multi disciplinary rounds that has positively impacted customer service. The sixth floor teamwork between all disciplines resulted in a customer service rating from

Sophia has supported the department with participation in a variety of special projects and activities within the organizational forum. She is of the highest professional standard, dependable and accountable and she continues to be an asset to this department, the sixth floor and North Broward Medical Center.

Mary Lou Dolan, R.N., is a 23 year employee of the North Broward Hospital District and has been part of the Case Management department at North Broward Medical Center for over 16 years. She transitioned to the Emergency Department seven years ago as the ED case manager. During her tenure at North Broward Medical Center, Mary Lou has maintained a high level of involvement within the organizational forum. She is a resource person for the hospital and a mentor to all new case manager employees. She is very active in a variety of initiatives that are above and beyond her job description and performance expectations within the department and hospital.

Most recently, Mary Lou received the Excellence Award for the design, creation and presentation of the showcase storyboard for Quality Expo on “The Little Engine That Could”. Also, her assistance in the research and writing of the prestigious Franklin Award application for the department was critical. This award submission allowed the department to showcase our work and talents on a nationally recognized platform.

Mary Lou is proactive in identifying needs and issues within the case management department, emergency department, and North Broward Medical Center. She independently identifies and seeks alternatives and solutions to the issues and needs, and frequently is asked to participate on committees and review teams to ensure the highest of quality and compliance. She also takes the initiative to educate and facilitate others within the team. This is apparent by her ability to effectively address issues with the medical staff and empower the nurses with the resource knowledge to be proactive during off hours. She is acutely aware of and manages the available resources effectively to achieve positive quality outcomes.

Mary Lou comes to work with a positive attitude prepared to work in whatever capacity needed. She is a leader in the department that is of the highest professional standard, dependable and accountable. She is a tremendous asset to this department, the ED and this facility.