MDS Coordinator RN

OVERVIEW:

MDS Coordinator administers patient assessments and oversees the assessment process, setting the assessment schedules and assuring that assessments are done in an accurate and timely manner.

MDS Coordinator coordinates the care plan as according to regulatory requirements. Ensure that resources are made available to patients and that patient care is delivered effectively and to a satisfactory standard. Create the schedule for all Medicare and Medicaid. Start Medicare coverage for newly qualified patients or send out denial letters and remain updated on changes in Medicare coverage and help determine documents needed for reimbursement.

RESPONSIBILITIES:

• Oversees accurate and thorough completion of the Minimum Data Set (MDS), Care Area Assessments (CAAs) and Care Plans, in accordance with current federal and state regulations and guidelines that govern the process

• Acts as an in-house Case Manager demonstrating detailed knowledge of residents’ health status, critical thinking skills to develop an appropriate care pathway and timely communication of needed information to the resident, family, other health care professionals and third-party payers

• Proactively communicates with Administrator and Director of Nursing to identify regulatory risk, effectiveness of Facility/Community Systems that allow capture of resources provided on the MDS, clinical trends that impacts resident care, and any additional information that influences the clinical and operational outcomes of the Facility/Community

• Utilizes critical thinking skills and collaborates with therapy staff to select the correct reason for assessment and Assessment Reference Date (ARD). Captures the RUG score which reflects the care and services provided

• Demonstrates an understanding of MDS requirements related to varied payers including Medicare, Managed Care and Medicaid

• Ensures timely electronic submission of all Minimum Data Sets to the state data base. Reviews state validation reports and ensures that appropriate follow-up action is taken

• Facilitates the Care Management Process engaging the resident, IDT and family in timely identification and resolution of barriers to discharge resulting in optimal resident outcomes and safe transition to the next care setting

• Directly educates or provides company resources to the IDT members to ensure they are knowledgeable of the RAI process. Provides an overview of the MDS Coordinator and Assessor role to new employees that are involved with the RAI process. Teach and train new or updated RAI or company processes to interdisciplinary team (IDT) members as needed

• Analyzes QI/QM data in conjunction with the Director of Nursing Services to identify trends on a monthly basis

• Responsible for timely and accurate completion of Utilization Review and Triple Check

• Serves on, participates in, and attends various other committees of the Facility/Community (e.g., Quality Assessment and Assurance) as required, and as directed by their supervisor and Administrator

QUALIFICATIONS:

EDUCATION / EXPERIENCE:

• Bachelor’s in Nursing

• Proficiency in MDS 3.0

• Demonstrating knowledge of state and federal regulations

• Registered Nurse with current, active license in the state employed

• Minimum two (2) years of clinical experience in an LTC setting

• Prior experience as an MDS coordinator

SUPERVISORY RESPONSIBILITIES:

• This position has no supervisory responsibilities.

WORK ENVIRONMENT:

• This job operates in a health care setting.

• This role requires regular walking to various locations around the care center

• May be required to work extended periods of time at a video display terminal

• The employee is occasionally exposed to a variety of patient conditions and elements

• The noise level is moderate to quiet

PHYSICAL REQUIREMENTS:

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

• This position is very active and requires standing for long periods of time, walking throughout facility, bending, kneeling and stooping all day.

• The employee must frequently lift or move objects and patients weighing over 20 pounds.

• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

TRAVEL:

• No Travel is expected for this position