MDS-RN

JOB TITLE: MDS-RN

JOB CODE: 28

DEPARTMENT: NURSING

FLSA STATUS: NON-EXEMPT

REPORTS TO: ADMINISTRATOR

JOB SUMMARY: The MDS Coordinator will assist the Director of Nursing with ensuring that documentation in the center meets federal, state and certification guidelines. The MDS-RN will coordinate the RAI process ensuring the timeliness and completeness of the MDS, CAAS and Interdisciplinary Care Plan.

ESSENTIAL FUNCTIONS:

• Assist the facility in assuring adherence to federal and state regulations and certification
• Actively participate in the regulatory or certification survey process and the correction of deficiencies
• Report trends from completed audits to the Quality Assurance Committee
• Ensure completion of the RAI Process from the MDS through the completion of the plan of care
• Initiate and monitor RAI process tracking, discharge/re-entry, and Medicaid tracking forms through the PCC & SimpleLTC systems
• Follow up with staff when necessary to ensure compliance to standards of documentation
• Collect data for each resident and interviews staff and residents as necessary to assure good standard of practice and as instructed in the most current MDS user manual
• Facilitate accurate determination of the Assessment Reference Date that accurately reflects the patient's care needs and captures all resources utilized to ensure appropriate payment by Medicare/Medicaid and insurance programs
• Provide interdisciplinary schedule for all MDS assessments and care plans as required by OBRA and PPS
• Ensure appropriate signatures are obtained as required
• Ensure that the interdisciplinary team makes decisions for either completing or not completing additional MDS assessments based on clinical criteria as identified in the RAI manual
• Respond to change in conditions appropriately
• Coordinate scheduling notice of patient care planning conference and ensure communication of outcomes/problems to the responsible staff, patient and/or responsible party
• Ensure all MDS information and care delivered as outlined in the Care Plan is supported by documentation
• Assist the Administrator/Director of Nursing with monitoring to ensure that a care plan is initiated on every patient upon admission to the center
• Participate in the daily Interdisciplinary Team meeting and communicate needs for changes in PPS Timeliness and Assessment Reference Dates and deficiencies in completion of MDS, CAA and Care Plan
• Relay and/or act upon information from the Clinical Reimbursement Specialist audits
• Act as a resource person for computer issues that relate to the MDS process; contact the help desk when indicated
• Maintain proficiency in software programs
• Responsible for ensuring appropriate Medicare coverage through regular communication with Clinical Reimbursement Specialist Sequence appropriate diagnosis coding for residents
• Correct and ensure completion of final MDS and submit resident assessment data to the appropriate state and Federal government agencies in a timely manner
• Assign, assist and instruct all staff in the RAI Process, PPS Medicare, Medicaid (Case Mix as required) and clinical computer system in relation to these processes
• Ensure timely submission of the MDS to the state with proper follow up on validation errors; maintains validation records from the submission process in a systematic and orderly fashion
• Maintain confidentiality of necessary information
• Remain proactive with staying current on all industry changes
• Assist with OIG reviews, ADR's, RAC audits, etc. as needed with professionalism
• Coordinates monthly Triple Check meeting for Medical billing compliance
• Complete LTCMI timely on TMHP portal and communicate with BOM regarding payer changes to ensure no loss in Medicaid payment
• Understand and adhere to the guidelines of “Residents Rights” and assure resident safety