JOB SUMMARY: The MDS-LVN will assist the Director of Nursing with ensuring that documentation in the center meets federal, state and certification guidelines. The MDS-LVN will coordinate the RAI process ensuring 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

• Facilitate accurate determination of the Assessment Reference Date that accurately reflects the patient's care needs and captures all resources utilized to ensure

• 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

• 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

• 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

• 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

• 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

• 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

• Coordinate 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

QUALIFICATIONS:

Required

• Current LVN license

• CPR certified required; 30 days will be given to complete a course and get certified

• Excellent knowledge of RAI Process, the federal Medicare PPS process, and Medicaid reimbursement as required

• Thorough understanding of the Quality Indicator process

• Knowledge of the OBRA regulations and Minimum Data Set Knowledge of the care plan process

Preferred

• 2 years nursing experience in long term care/skilled nursing