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Acute Care Nurse Salary in Alabama, USA

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Acute Dialysis Nurse

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Assessment Nurse

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Behavioral Health Nurse

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Case Manager Nurse

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Charge Nurse

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Clinical Nurse Specialist

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CNA

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Community Health Nurse

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Correctional Nurse

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Corrections Nurse

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Critical Care Nurse

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Dialysis Nurse

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Director Of Nursing

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Emergency Room Registered Nurse

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Employee Health Nurse

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Endoscopy Nurse

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Geriatric Nurse

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Hospice Nurse

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Hospital Nurse

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Icu Nurse

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Infection Control Nurse

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Infusion Nurse

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Intensive Care Nurse

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Lpn Charge Nurse

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Medical Surgery Nurse

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Mental Health Nurse

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Neonatal Nurse

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Nurse

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Nurse Anesthetist

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Nurse Assistant

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Nurse Clinician

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Nurse Consultant

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Nurse Coordinator

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Nurse Extern

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Nurse LVN

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Nurse Reviewer

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Nurse RN

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Nurse Supervisor

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Nursing Assistant

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Occupational Health Nurse

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Office Nurse

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Operating Room Nurse

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Palliative Nurse

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Pediatric Nurse

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Pediatric Travel Nurse

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Perioperative Nurse

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Postpartum Nurse

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Practice Nurse

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Psychiatric Mental Health Nurse

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Psychiatric Nurse

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Psychiatric Registered Nurse

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Public Health Nurse

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Radiology Nurse

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Resource Nurse

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Restorative Nurse

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School Nurse

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Surgical Nurse

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Telemetry Nurse

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Travel Nurse

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Utilization Review Nurse

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Vocational Nurse

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Womens Health Nurse

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Hospice House Registered Nurse Nights
VISITING NURSE SERVICE AND HOSPICE OF SUFFOLK, NORTHPORT
7 (12.5 hours) shifts per pay period with some on-call responsibilities Duties and Responsibilities: Adheres to infection control practices and all agency policies and procedures Utilization of the nursing process to identify patient centered goals, (physical, psychosocial and environmental, physical assessment, plan, implementation and evaluation.) Uses an interdisciplinary team approach to meet these goals, under the direction of the Hospice House MD/NP with the most efficient use of resources. Use of clinical guidelines of end stage diseases to determine patient prognosis. Is knowledgeable regarding the Hospice Medicare Benefit. Functions as part of the Interdisciplinary Team and refers to other team members as needed to ensure the physical emotional and spiritual well being of the terminally ill. Is knowledgeable with medications used at end of life for pain and symptom management. Assesses patient needs related to end of life and communicates with hospice NP/MD when there are changes in the patient's condition that may require medication changes. . Is kind and compassionate when communicating and caring for patients and their families/caregivers related to end of life symptoms and management. Advocate for comfort needs of the hospice patient with primary physician and Hospice House Maintains the comfort and quality of life for those patients in the Hospice House. Maintains compliance with Narcotic distribution, administration, and disposal in accordance with Department of Health and VNSHS policy. Documents with accuracy and completeness consistent with Medicare guidelines that demonstrate measurable outcomes and GIP level of care. Under the direction of the Clinical Manager/DPS assist with the orientation of new staff and students when needed. Oversees and participates in the direct care-giving of Hospice House patients; coordinates and directs the HHA care plan and supervision of the nurse's aide in care of the patient. Documents notes for IDG meetings as specified. Notes to include patient's reason for hospice care, progress towards patient centered goals, symptoms to be managed, medication changes and interventions. Document effectiveness of all interventions and disciplines. Effective and professional communication with other companies/agency's that are involved in patient care i.e.: IV companies, funeral homes, spiritual advisors etc. Effective use of voice mail and email. Promptly responds in a timely manner to corrections. Provides mandated federal and stare notices to patient to include, but not limited to, NYS Provision of Care, Home Health Beneficiary notice and Notice of Medicare non coverage. Communicates with all other disciplines involved in patients care and documents same. Participation in continuing education (minimum of 3 hours per calendar year), attending annual competency and all mandatory in-services, including use of patient restraint/seclusion. Attendance at team meetings. Has a high ethical standard related to all aspects of Hospice care. Employee adheres to all applicable federal, state, local laws and regulations. Other duties as assigned. Qualifications: A registered professional nurse currently registered and licensed to practice nursing in the state of New York. A Baccalaureate Degree in Nursing from an accredited college or university preferred. Two years' experience in the delivery of nursing care in a Certified Home Hospice Agency preferred. A combination of education and experience equivalent to above and acceptable to New York State Health Department. Must be familiar with hospice care and its implementation. Skilled in the ability to observe and assess the health care needs of Hospice patients and families. Knowledge of care of cancer patient, pain management and Hospice concept. Skilled in the techniques of therapeutic communication. Able to facilitate cooperation and communication among members of the staff. Able to coordinate the resources of VNS & Hospice of Suffolk, Inc. personnel. Possess supervisory and management skills. Physical/Cognitive Requirements: Physical agility in the form of being able to ambulate, drive a motor vehicle, and negotiate stairs. Vision acuity correctable to normal with normal color perception. Hearing acuity correctable to normal. Acute sense of smell for normal perception. Ability to verbalize so that the average person can comprehend.
Nurse Practitioner - House Calls
The Judge Group Inc., Birmingham
Location: Birmingham, ALDescription: The Judge Group is looking for Nurse Practitioners to perform in-home health assessments on Medicare Advantage Members with one of the largest healthcare providers in many counties across Alabama.....Jefferson or....Cullman, DeKalb, Etowah, Marshall, Morgan, St. Clair, Tuscaloosa, Walker, or many others.Pay - HIGHLY competitive, paid per assessment - dependent upon experienceContract - ongoing (no end date)Schedule - PART TIME or FULL TIME opportunitiesAll training and equipment provided by clientW2 positionOverview:A House Calls Nurse Practitioner will complete in home health assessments on patients within a geographic area of responsibility (county). The nature of the House Calls visit is to complete annual health assessments on Medicare Advantage members, each assessment ranging from 45-90 minutes in length. House Calls hours of operation are Monday-Sunday 8am to 8pm. Weekend hours are allowed if that works with your schedule. Qualifications:Minimum 6 months experience working as a NP when you start the roleNP license and national certification (ANCC or AANP, or the ability to obtain national certification and/or NP license in state of assignment) active, unencumbered licensure free any open/unresolved disciplinary actions including probation or restrictions against privilege to practiceAll board certifications accepted EXCEPT PMHNP or WMNPExperience in gerontology, cardiology, internal medicine, or endocrinology a plus.Home Health care or home visit experience is a plus.If you or someone you know is interested can contact, Mike Ferry at [email protected] with an updated CV/resume, or call 215-309-7289. I look forward to working with you! Contact: [email protected] job and many more are available through The Judge Group. Find us on the web at www.judge.com
Post-Acute Nurse Practitioner in Montgomery, AL
TeamHealth, Montgomery, AL, US
TeamHealth is seeking a weekend nurse practitioner (NP) to join our growing post-acute care practice in the Montgomery, Alabama area. Provide quality compassionate primary care to adults in skilled nursing facilities. This is an excellent opportunity to further your career and make a difference in the lives of patients and families in these communities.TeamHealth currently provides post-acute primary care services to 30+ facilities across the state of Alabama.Previous experience in a post-acute, skilled nursing facility, or long-term care setting is preferred. Current Alabama NP license and DEA is required.Interested in learning more? Apply today!California Applicant Privacy Act:  https://www.teamhealth.com/california-applicant-privacy-notice/- Customize your own schedule to create your ideal work/life balance- Unmatched flexibility- Highly competitive weekend fee-for-service pay- Paid professional liability insurance with tail coverage- 50-day onboarding program- Well-developed infrastructure with extensive back-office support- EMR training and support with Company issued iPad with gEHRimed EMR- Opportunities to collaborate with other clinicians- Access to professional development tools, educational resources, and CME through the TeamHealth Institute and AMDA
Registered Nurse Rn-dialysis
Kommforcesolutions Inc., Selma, AL, US
Registered Nurse (RN) Dialysis: Full TimeMust-Haves:Registered Nurse in Alabama1 year of dialysis experience1 year of acute care experienceBCLS - Basic Cardiopulmonary Life SupportNice-To-Haves:ACLS - Advanced Cardiac Life SupportAbout the Opportunity:Provides dialysis treatments for all renal patients and coordinates care with primary nurse and ancillary departments. Assists the nephrologist with ordered dialysis procedures. Performs the hemodialysis treatment maintaining established standards for nursing practice in a clinical setting.Qualifications:Current AL Registered Nurse licenseACLS preferredBCLS requiredA minimum of 6 months dialysis experience requiredAcute dialysis experience preferred.Medical Specialties: DialysisPhysical Setting: Acute careStandard Shift: Day shiftSupplemental Pay Types: Signing bonusSupplemental Schedule: Holidays, OvertimeWeekly Schedule: Monday to Friday, Rotating weekends
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Physician Assistant OR Nurse Practitioner Mobile, AL
Healthcare Recruitment Counselors, Mobile, AL, US
Physician Assistant OR Nurse Practitioner Mobile, ALCompetitive compensation with production bonus!We are looking for a motivated Physician Assistant or Nurse Practitioner to join our growing medical team at our busy office full time in Mobile, AL. We are looking for a PA or NP to focus on helping our patients decrease pain and restore function so that they can live happier, healthier, and more active lives. We are driven by our compassion, respect, and concern for every patient we serve, and we are looking for a likeminded provider to join us! We offer a great lifestyle, no call/holidays, competitive salary with productivity bonus! Office hours end early on Fridays. Low hours with a high impact, we prioritize efficiency and provide a supportive environment that allows our PA/NPs to maintain a reasonable workload and enjoy a fulfilling career. Joint a team committed to continuous learning and professional development with opportunities for advancement.Are you passionate about caring for patients? Love providing individualized care in a state-of-the-art facility with an excellent support staff and team? Join us and you can be a part of a knowledgeable, dynamic team who treat a variety of conditions and age ranges. The Nurse Practitioner/Physician Assistant is responsible for evaluating, diagnosing, and managing patient's pain issues in accordance with the standard of care.About us:We are a multispecialty team comprised of Physicians, PA/NP’s, Physical Therapists, Nurses and Practitioners who collaborate to relieve the pain, restore physical function, and empower our patients to renew themselves so they can enjoy the lives they want and deserve. We have an integrated, comprehensive system of treatments focused on decreasing pain and restoring function.Duties:• Patient exam/evaluation to include medical history, relevant imaging/studies• Utilizes a multimodal approach to include but not limited to medication, physical therapy and bracing where appropriate• Interprets medical tests in the context of patient care and explains results to patients• Completes all administrative tasks in a timely manner• Monitors patient's compliance to treatment plan (i.e.: obtaining urine drug screens, where applicable)• Adheres to company policies, ongoing quality improvement objectives and safety, environmental, and infection control standards• Maintains patient confidentiality and complies with all federal and state health information privacy laws• Records complete, timely and legible medical records• Liaises with other medical professionals related to patient care• Keeps up to date with medical developments• Promotes the company's core values• Coordinates with medical assistants, nurses and other medical staff• Ensures all personnel and all patients are treated without limitation because of race, creed, sex or national origin• Collaborates with administrative team to optimize the Clinic functionality• Assists with marketing, as needed• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks and participating in professional societies• Checks work e-mail on a regular basis throughout the workday• Participates in and complete all required trainings and in-servicesRequirements:• Graduation from an Accredited Physician Assistant or Nurse Practitioner Program• PA-C/NP Licensed in ALGenerous Compensation and Benefits!The mission of our company is that we are dedicated to relieving pain, restoring function, and renewing our patient’s quality of life through a comprehensive and compassionate approach to treatment. We do this so that patients can get back to living their best life, the one they want and deserve. Are you passionate about bringing quality care and compassion to your patients? Ready to join our dynamic group that is solely focused on patient care, health, and well-being? If so, we want to hear from you!Please send your resume to Brian Torchin.Brian Torchin / CEOHCRC Staffing
Nocturnist Nurse Practitioner openings in Southeast Alabama
GO Staffing, Dothan, AL, US
Well respected Healthcare care system in Southeast Alabama is seeking a Nocturnist Nurse Practitioner Acute Care Nurse Practitioner (ACNP or AGACNP)7on/7off, 7p-7a for Nocturnists (Monday-Sunday schedule).NO Call.Seeking candidates with Hospitalist/Nocturnist NP experienceWill be rounding only (no admissions, Codes or procedures).Epic EMR.Competitive salary, full benefits, loan repayment/sign-on/relo all negotiable.Job ID #4339
Hospice House Registered Nurse Nights
VISITING NURSE SERVICE AND HOSPICE OF SUFFOLK, Northport
7 (12.5 hours) shifts per pay period with some on-call responsibilities Duties and Responsibilities: Adheres to infection control practices and all agency policies and procedures Utilization of the nursing process to identify patient centered goals, (physical, psychosocial and environmental, physical assessment, plan, implementation and evaluation.) Uses an interdisciplinary team approach to meet these goals, under the direction of the Hospice House MD/NP with the most efficient use of resources. Use of clinical guidelines of end stage diseases to determine patient prognosis. Is knowledgeable regarding the Hospice Medicare Benefit. Functions as part of the Interdisciplinary Team and refers to other team members as needed to ensure the physical emotional and spiritual well being of the terminally ill. Is knowledgeable with medications used at end of life for pain and symptom management. Assesses patient needs related to end of life and communicates with hospice NP/MD when there are changes in the patient's condition that may require medication changes. . Is kind and compassionate when communicating and caring for patients and their families/caregivers related to end of life symptoms and management. Advocate for comfort needs of the hospice patient with primary physician and Hospice House Maintains the comfort and quality of life for those patients in the Hospice House. Maintains compliance with Narcotic distribution, administration, and disposal in accordance with Department of Health and VNSHS policy. Documents with accuracy and completeness consistent with Medicare guidelines that demonstrate measurable outcomes and GIP level of care. Under the direction of the Clinical Manager/DPS assist with the orientation of new staff and students when needed. Oversees and participates in the direct care-giving of Hospice House patients; coordinates and directs the HHA care plan and supervision of the nurse's aide in care of the patient. Documents notes for IDG meetings as specified. Notes to include patient's reason for hospice care, progress towards patient centered goals, symptoms to be managed, medication changes and interventions. Document effectiveness of all interventions and disciplines. Effective and professional communication with other companies/agency's that are involved in patient care i.e.: IV companies, funeral homes, spiritual advisors etc. Effective use of voice mail and email. Promptly responds in a timely manner to corrections. Provides mandated federal and stare notices to patient to include, but not limited to, NYS Provision of Care, Home Health Beneficiary notice and Notice of Medicare non coverage. Communicates with all other disciplines involved in patients care and documents same. Participation in continuing education (minimum of 3 hours per calendar year), attending annual competency and all mandatory in-services, including use of patient restraint/seclusion. Attendance at team meetings. Has a high ethical standard related to all aspects of Hospice care. Employee adheres to all applicable federal, state, local laws and regulations. Other duties as assigned. Qualifications: A registered professional nurse currently registered and licensed to practice nursing in the state of New York. A Baccalaureate Degree in Nursing from an accredited college or university preferred. Two years' experience in the delivery of nursing care in a Certified Home Hospice Agency preferred. A combination of education and experience equivalent to above and acceptable to New York State Health Department. Must be familiar with hospice care and its implementation. Skilled in the ability to observe and assess the health care needs of Hospice patients and families. Knowledge of care of cancer patient, pain management and Hospice concept. Skilled in the techniques of therapeutic communication. Able to facilitate cooperation and communication among members of the staff. Able to coordinate the resources of VNS & Hospice of Suffolk, Inc. personnel. Possess supervisory and management skills. Physical/Cognitive Requirements: Physical agility in the form of being able to ambulate, drive a motor vehicle, and negotiate stairs. Vision acuity correctable to normal with normal color perception. Hearing acuity correctable to normal. Acute sense of smell for normal perception. Ability to verbalize so that the average person can comprehend.
Internal Agency Virtual Interview Day - (4/24/24) Acute Care/MedSurg 7a-7p & 7p-7a Shifts
Wellstar Health System, Inc., Birmingham
Job Summary:The Internal Agency RN Clinical Nurse- Acute Care is a proactive member of an interdisciplinary team of licensed and unlicensed care givers who ensure that patients, families, and significant others receive individualized high quality, safe patient care. They practice in a clinical environment that is administered by Nurse Managers and other leaders and is supported through the WellStar Shared Governance Model. The framework for practice is steered by the WellStar Professional Practice Model, 5-Star Nursing and evidence-based practice and research. RN competencies are derived from these models and supported by the WellStar Core Competencies.It is expected that all RN Clinical Nurses are licensed, knowledgeable and uphold the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association. As a member of the patient services team, it is expected that the individual upholds the voice of the patient, system policies and procedures while supporting service excellence goals.Core Responsibilities and Essential Functions:Exemplary Practice and Outcomes- Performs the Nursing Process (assessment; diagnosis; identification of outcomes; planning;- implementation and evaluation) in the performance of clinical care using evidence base practice, uses- analytical/critical thinking and insuring that care is individualized; coordinating care through effective- partnerships recognizing that caring is central to achieve optimal patient care outcomes- Provides relationship-based patient centered care that is consistent with population specific- characteristics (e.g. age, gender, disease, etc.) in a manner that adapts service delivery to reflect an- understanding of cultural diversity- Always partners with the patient and significant others (as appropriate) using such appropriate method- for setting and purpose (e.g., bedside shift report; interdisciplinary rounds; just in time and planned- patient teaching; keeping the patient and significant others updated and making the patients goals the- Workforce Operations V1.0 Internal Agency RN Clinical Nurse- Acute Care- focus of the plan of care.- Practices using current clinical practice standards. Teamwork and Collaboration- Coordinates the delivery and documentation of safe quality patient care that promotes the professional- care delivery model. This includes, but is not limited to diverse and inclusive interdisciplinary- communication methods (interdisciplinary rounds, case review, etc.); completion of timely- documentation and promotion of a respectful, inclusive clinical environment- Demonstrates teamwork and collaboration by practicing in a manner that is fiscally responsible and- promotes the recruitment and retention of all healthcare team members.- Participates and supports performance improvement inclusive of all stakeholders, research- and research utilization to promote safe, quality patient care including initiating and/or leading- such activities as well as, promoting an inter/intra-disciplinary process and actively- supports/participates in shared governance at all levels in the system. Professional Development and Initiative- Completes all initial and ongoing professional competency assessment, required mandatory education,- population specific education.- Serves as a preceptor and/or or mentor for other professional nurses (and staff or students for- all disciplines) to ensure that there is a current and future qualified workforce; modeling the- professional practice of nursing and creating a healthy work environment Evidence Based Practice and Research- Promotes Evidence based practice, nursing research and performance improvement in nursing.- Participates in activities such as value analysis as part of the decision making process in evaluating- patient care products.- Upholds all health care system/organizational policies and procedures and clinical competencies put- forth by this job description and professional association including legal, regulatory and accreditation- requirements and standards ensuring by way of example, such goals as TJC Patient Safety Goals and- WellStar Health Systems safety absolutes- Participates in data collection, poses relevant clinical questions to advanced evidence based- practice. Consults appropriate experts and uses appropriate resources and evidence to- address practice questions. Resources and Support- Proactively plans for the care of patients across the care continuum in the course of giving direct- patient care.- Participates in the development of protocols and procedures when called upon or through self-- initiation in collaboration with care managers and other members of the health care team to achieve- best practice outcomes (i.e., decrease in re-admission rates; avoidable days; adverse events; etc.).- Supports efficient and effective use of human and material resources.Required Minimum Education:Associate's Degree Graduate of an accredited/approved school of nursing RequiredBachelor's Degree Baccalaureate degree in nursing (BSN) from an accredited school of nursing PreferredRequired Minimum License(s) and Certification(s):All certifications are required upon hire unless otherwise stated.Basic Life Support or BLS - InstructorReg Nurse (Single State) or RN - Multi-state CompactAdvanced Cardiac Life Support or ACLS - Instructor or ACLS - ProvisionalAdditional License(s) and Certification(s):National certification in area of specialty preferred Upon Hire PreferredRequired Minimum Experience:Minimum 1 year of Experience RequiredMinimum 2 years of Experience PreferredRequired Minimum Skills:Ability to read, write and speak English language, optimize the use of technology tosupport clinical care and holds basic computer skills.Strong interpersonal, collaborative skills along with customerservice skills required.Ability to function in a fast paced environment and respond to emergencies in using adecisive, composed and respectful manner.Possess excellent time management skills.practices nursing usingevidence and analytical skills along with possessing strong critical thinking skills.
LPN/LVN or RN Value Based Care Nurse- Mobile, AL and Surrounding Counties (Onsite at Providers Office)
Cigna, Mobile
Job DescriptionPrimary Function:Coordinate and manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR/ CAHPS performance measures. Develop and maintain a process to ensure all customers in participating provider practices meet all quality metrics. Supports the delivery of cost-effective, quality -based health care services for health plan customers by development and implementation of alternative treatment plans that address individual needs of the customer, their benefit plan, and community resources. Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan. Utilizes clinical skills to assess, plan, implement, coordinates, monitor and evaluates options and services in order to facilitate appropriate healthcare outcomes for customers.Responsibilities:Identifies Quality gaps and metrics for customers and communicates to providerReview STAR summary gap report (daily) by payorReviews Arcadia polychronic reportsClinical review of charts for clinical documentation integrity ( # Charts Reviewed to TBD by polychronic report threshold)Query provider based on clinical chart findingsFollow up and track provider query's (weekly)Maintains physical presence in participating provider practicesIdentifies high-risk/high-cost patients for possible case management intervention and refers to appropriate clinical program.Interfaces with providers of medical services and equipment to facilitate effective communication, referrals, supports discharge planning, and alternative treatment plan development.Identifies customer needs, coordinates and supports planned and unplanned transitions and post discharge follow up calls which may include primary care physician and specialist appointment schedulingNurse notifies PCP daily of admissions and dischargesCollaborates with the attending physician to achieve identified patient outcomes.Tracking of monthly IPM reports by PCPAttend and participate in weekly team or provider meetingsCollaborates with supervisors, team members, and utilizes buddy system for back up coveragePerforms telephonic outreach as directedCommunicates with all departments to resolve issuesUnderstands and follows administrative guidelines (policy and procedure) of the departmentAttends and actively participates in staff meetings.Requires on camera participationAttends clinical documentation integrity trainingProvides detailed clinical chart review to verify chronic conditions and related symptomsSupport Chart reviews and Pulls medical records for HEDISSupports Health Plan with CAHPS and STARS initiativesExtract data as needed and document in appropriate systemOther Duties as assigned.Supervisory Responsibilities:NoneJob Related Skills:Utilizes critical thinking skillsVerbal and written communication skillsInterpersonal skillsBasic Mathematical and statistical abilityOrganizational skillsTyping and computer knowledge- able to type 35WPMKnowledge of utilization review requirements and proceduresKnowledge of current health care practices and appropriate treatments.Knowledge of community resourcesAbility to travel to and work at participating provider officesWorks independently with minimum of supervisionBilingual - preferred Spanish both conversational and writtenExperience:Current Licensure as a LPN/LVN or RN , in the state of residence in good standing.Associates degree, diploma or B.S. in NursingThree to Five (3-5) years recent experience in an acute-care environment, case-management or utilization management position (experience can be a combination of LVN/RN licensure)Previous HEDIS and/or CMS STARs experience a plus Role requires working onsite at providers office. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.