Salute to Case Managers

 

Yasiri Perez, MSW, is the regional manager of social services for Palm Beach PACE (Programs of All-Inclusive Care for the Elderly) in affiliation with MorseLife Health System. In addition to her own caseload, she manages nine social workers to serve approximately 600 frail older adults at their homes and at MorseLife PACE centers throughout Palm Beach County. With a goal of preventing unnecessary nursing home admissions, she oversees services that include: primary and specialty medical care; skilled home care and medical aides; physical, occupational and speech therapies; medication management; adult day care; home health care and end of life care. Yasiri joined MorseLife five years ago from Kids In Distress where she was involved in the licensing of foster parents. After completing her undergraduate studies at the University of Central Florida, she received her Master of Social Work from Florida Atlantic University.

 

 

Judy Uzzi, LCSW, CMC, serves as the clinical program director of the MorseLife Care Management and Counseling Program. A licensed clinical social worker with more than 35 years of experience, Judy oversees a staff providing counselling and care management to a fragile senior population, most of whom are between the ages of 80 and 100 living with chronic conditions. During the pandemic she has led innovations in the delivery of care to include telehealth while also providing the technological training and opportunities for patients to connect with family members. Judy also draws on her experience in hospice and long-term care to help foster discussions enabling patients and families to make end-of-life decisions. Judy joined MorseLife more than 20 years ago from Just Checking care coordination services at Barry University. She graduated from Adelphi University in Garden City, NY and is an accredited CME through the State of Florida.

 

 

Mary Monahan has been a case manager at Broward Health Coral Springs for the last 12 years, and in 2014 was promoted to her current role as case manager coordinator. Her duties include, but are not limited to, complex discharge planning, transition of care, reducing readmission and monitoring length of stay. She participates in multidisciplinary rounding with the hospitalists and works hand in hand with the Chief Medical Officer.

 

Monahan finds it rewarding it to be able to connect with patients through rounding. She also enjoys providing support to the case managers and social workers on complex issues. She has been instrumental in helping train staff and transition them to enhanced practice modules.

 

Her experience in clinical nursing background includes pediatrics, emergency care and critical care. And with her broad nursing background, she has the expertise to manage patients and families, identifying resources and searching for solutions that benefit her patients.

 

Monahan is certified in case management, has a Bachelor of Science in Nursing and a Master of Science in Healthcare Management.

              

 

Helen Guzzi has been a case manager at Broward Health Coral Springs for the past 11 years. She specializes in discharge planning and coordination of post-acute care services. She worked as a staff nurse for 24 years prior to her current role. This year, due to the COVID-19 pandemic, many challenges evolved in her role as case manager. The unit to which she was assigned was restructured and designated a COVID unit.

 

Guzzi has been tasked with keeping track of the ever-changing rules of COVID testing, discharge and transfer. She became highly regarded for her expertise when dealing with coordinating post-hospital care for COVID patients. She works with the insurance companies to have transfers and services authorized. She also assists families, explaining the process. She cultivates positive relationships with the families, which is an integral part of patient- and family-centered care.

 

Guzzi said her career in case management has its challenges, but it’s never boring, and at the end of the day it is the most satisfying career she could envision for herself. She graduated with a Bachelor of Science in Nursing from Centro Escolar University in Manila, Philippines.

 

 

Grace Walker, RN, is an acute care case manager at Broward Health Medical Center and works in the step-down intensive care, transplant and telemetry units. Her current role is to help ensure the safe discharge of all patients.

 

“My favorite part of being a case manager is to advocate for the well-being of patients and families by demonstrating empathy and compassionate all times,” said Walker. “I will do whatever is needed to facilitate the best plan of care for their recovery and a safe discharge.”

 

As a liver transplant recipient, she has also become a passionate advocate and local ambassador for the Life Alliance Organ Recovery Agency.

 

“I have been dedicated to raising awareness for organ donation and transplantation,” said Walker. “I have the unique advantage of being able to give hope and inspiration to pre- and post-transplant patients. I feel privileged to be working on the same unit as a case manager where I was a patient four years ago.”

 

Walker has been with Broward Health since 2005. She received her Associate of Science in Nursing from Broward College. She will begin her Bachelor of Science in nursing degree at Chamberlain University in January 2021. Walker has been a professional member of the American Holistic Nurses Association, American Nurses Association and the Oncology Nursing Society.

 

 

Beverley Harriot, a nurse case manager at Broward Health North, knows that working in healthcare is fast-paced, exciting and always a source for expanding her skillset. Her first job with Broward Health was in 2006, when she was hired as the operations manager of the outpatient lithotripsy center.

 

With a career that spans more than 40 years, her passion for caring for people has remained strong and has driven her to transition to case management, where she has been able to serve both patients and families, helping ensure safe transitions to the next level of care or home. By maintaining a high standard of care and through her wealth of experience, she continues to inspire nurses and social workers starting their careers in education, mentoring and leadership. Harriot’s vast clinical knowledge and compassion make her a strong asset to our healthcare system as she inspire her peers to elevate their own practice.

 

Harriot graduated from Essex County College in 1980 with an associate degree in nursing and later attained her bachelor’s degree in health services administration from Barry University.

 

 

Barbara Lay-Konitzer, a social worker at Broward Health North, is driven by the positive impact she has made for people during her career in healthcare that spans more than two decades. Her optimism is a source of inspiration for her colleagues, and her dedicated work ethic allows her to fully provide her patients and their families all relevant resources that may improve upon quality of life once her patients transition back into the community.

 

Lay-Konitzer began her career as a social worker for Women in Distress, a non-profit dedicated to helping women who have suffered from domestic violence. She worked within the Broward shelter providing counseling, training and empowerment to the agency’s clients. Since then, she has spent 16 years of her career serving psychiatric patients within acute care behavioral health units and though private practice. This population afforded her not only valuable interpersonal clinical experience, but infinite resilience.

 

As a valuable resource to her department, Lay-Konitzer brings a wealth of experience. She now primarily serves patients in the Emergency Department, because she is easily able to meet the high demand of the department and identify solutions for individuals in distress or in need of referrals to find the help they need.

 

Lay-Konitzer has a Master of Social Work from Barry University. She obtained her LCSW and is a Clinical Supervisor for licensure-seeking MSW individuals.

              

              

A nurse for nearly 40 years and a case manager for 10, Carolyn Ayers is a critical link to helping patients transition to a new way of life following inpatient rehabilitation at Memorial Regional Hospital South. With many of those she works with recovering from strokes, traumatic brain, and spinal cord injuries, it’s imperative they leave her facility with the proper equipment, aftercare, and emotional support. “They’re entering a different environment. I don’t want them to feel alone and even those with family assistance need someone who can make a difference within the system,” said Ayers.

 

Ayers considers patient advocacy to be one of her most important roles, citing the circumstances of a recent trauma patient that is now a quadriplegic. While his new situation will no doubt be filled with challenges, Ayers was able to help by arranging for disabled parking, setting up paratransit services, making referrals to support groups, and scheduling all the necessary doctor’s appointments that would be required in the time to come.

 

 

It’s always critical that case managers effectively communicate with patients and families, but those conversations have taken on additional meaning during COVID-19.

 

“Families are in need of constant contact, since the coronavirus has kept them from visiting loved ones at our hospital,” says Erica Solis, a case manager and social worker. “Their only connection may be the phone and we’re the go-between for the clinical staff, families, and the patient. It’s critical we’re all on the same page.”

 

Solis, who has been at Memorial Hospital Pembroke for the past three years, says she brings an added level of understanding to the COVID situation, since one of her own family members has had the virus. “It’s rewarding to safely transition someone from a COVID unit to wherever their next destination may be. These are different times, but there’s a lot of satisfaction in knowing you’re making a difference in someone’s life.”

 

 

While she doesn’t possess a magic wand to make things better, Lujuana Morales does bring the unique qualities of both a nurse and social worker and the resources of the Memorial Healthcare System to the patients she advocates for. Most recently, it’s been on behalf of those hospitalized with COVID-19 and their families at a time where visitation is prohibited. “I speak with them every day and let them know they’re not alone, that we’re here to support them, and to offer reassurance, encouragement, and resources,” said Morales.

 

It’s a message that’s welcomed by all those that hear it. “Lujuana connects in a way that few people can,” said Patricia Wilds, director of clinical effectiveness at Memorial Hospital Miramar. “Her care and compassion come through in every conversation. She’s been a lifeline for many families during the pandemic.”

 

“I know I’m in the right place,” said Morales, “and I look forward to many more years serving and advocating for those in need.”

 

 

With nearly four decades healthcare experience under her belt, first as a medical surgical unit nurse and now in case management, there aren’t many situations Maria Judith Miranda hasn’t encountered. That, she believes, is a big advantage for the patients and families she works with. “My background enables me to be their biggest advocate. I have the knowledge that nurses have, an understanding of what insurance will cover, and am able to provide options after discharge from the hospital.”

 

Miranda says her goal is always to be clear, concise, and honest about what she believes is the appropriate action plan.

 

“Maria is known for her positive attitude and has the ability to remain calm and patient as she helps patients/families navigate and understand the next transitions of care,” said Cindy Kohn, director of clinical effectiveness at Memorial Regional Hospital. “This can be a very overwhelming and confusing time for them, but they are reassured that Maria is there to guide them.”

 

 

Managing cases in a pediatric setting can be difficult, especially when abuse is suspected, but Clinical Effectiveness Case Manager Martha Tinoco-Romero is up to the challenge. She is a key part of the team that works closely with social work and community liaisons. “Martha is an advocate for the most vulnerable children in our community,” said Rebecca Kordsmeier, director of clinical effectiveness at Joe DiMaggio Children’s Hospital.

 

It’s a role Tinoco-Romero accepts willingly, similar to how she approaches her other duties, which include working with COVID-19 patients and mentoring BSN students or fellow employees in the art of utilization review.

 

It’s that understanding of what insurance and community resources are available to patients and families that has enabled Tinoco-Romero to have success within the Memorial Healthcare System since 2003, including the last six years as a member of the children’s hospital team. “She is an outstanding employee,” said Kordsmeier.

 

 

Within the next few weeks, Yoli Bianchi will wake up and not report for duty at Memorial Hospital West. After more than two decades with Memorial Healthcare System, the longtime ICU nurse and case manager is retiring. “I’m excited. I’ll miss my MHS family, but am looking forward to focusing on myself and developing new skills.”

 

Bianchi’s legacy can be seen through the words and actions of fellow case managers, most of whom she trained for the job. “Yoli’s willingness to consistently and effortlessly go above and beyond for patients, families, and co-workers makes her truly one-of-a-kind,” said Kim Fego, director of clinical effectiveness at Memorial Hospital West. “Her knowledge, compassion, collaboration, and ability to make any situation better is what made her a top- notch case manager.”

 

Fittingly, Bianchi saved some of her best for last, helping patients and staff navigate COVID-19 and some of the most challenging times any South Florida hospital has faced.