Description

Job Summary:

The MDS Coordinator will coordinate the nursing aspect of the RAI MDS, HCFA Medicare, DADS and RMHP programs, including screening for skilled care, pre-admissions, admissions, nursing documentation, evaluation and certification for continued stay. Monitor the assignment of patients to Resource Utilization Groups (RUGs), utilization of resources used in treatment and the assignment of RUGs payment periods associated with the Minimum Data Set (MDS) schedules. Works with the Business Office Manager to coordinate patient services utilization, RUGs and LTCMI payment categories, UB92 coding, and MESAVs. Develops and maintains ongoing MDS schedules for each patient. Coordinates and collaborates with the interdisciplinary team members, resident and families as appropriate, regarding patients plan of care. Ensures documentation is achieved, which supports the RAI MDS in clinical reporting. Performs general nursing duties as required.

The MDS Coordinator is responsible to the Director of Nursing.

Education:

Must be a Registered Nurse or Licensed Vocational Nurse. Must be a graduate of an accredited school of nursing currently registered with the state agency for nursing licensure and certification and hold a valid license in the state he/she is employed. Must have an maintain a License according to the Board of Nurse Examiners (BNE). Must continue to maintain background checks in good standing according to the requirements of Texas Department of Aging & Disability Services (DADS).

Qualifications

Qualifications:

1. Experience in long term care preferred. Experience in Medicare preferred but not required.

2. Has ability to work well with general public.

3. Demonstrates leadership and management ability.

4. Is capable of implementing changes as mandated by Federal, State and management suggestions.

5. Is of good emotional, mental and physical health, having sound judgment and high professional standards.

6. Maintains a neat, well-groomed and professional appearance at all times.

7. Must be willing to be in the facility working with the staff of each shift if need arises.

8. Must be willing to be in and/or available to the facility week-ends as well as week days as needs arise.

9. Must demonstrate the ability to function as a cooperative team member with all disciplines in the facility.

10. Is willing and capable of providing emergency care as needed for any resident in the facility.

11. Experience in case management, rehabilitation nursing, long term care, Medicare nursing documentation and Minimum Data Set (MDS) coding preferred.

12. Demonstrates an attitude for providing a high degree of patient satisfaction and services.

13. Demonstrates experience working in a positive collaborative relationship with members of the community.

14. Must have a pre-employment and an annual Tuberculosis test and/or screening.

RESPONSIBILITIES:

1. Works closely with admissions to assess all inquiries for possible Medicare admissions.

2. Visits or arranges for the visit of an appropriate clinical representative to pre-screen potential patients on-site at the referring facility, agency, or hospital.

3. Screens all new admits and readmissions for skilled care and facility policies and procedures.

4. Interacts with discharge planners and staff from referring facilities, agencies and hospitals to pre-screen potential patients for admission and readmission to the facility.

5. Responsible for skilled nursing documentation on Medicare patients, either through actual documentation or audits.

6. Responsible for all required nursing documentation for Medicare nursing to include any other record keeping required by the program for nursing.

7. Assesses Medicare residents for continued stay on continuous basis and tracks remaining days in unit.

8. Manage and collaborates with the MDS Team on pre-admission screening, assignment of observation and look-back periods; informs the interdisciplinary team regarding changes in look-back periods for the MDS completion including the implementation of a "significant change" MDS/plan of care processes.

9. Assigns the admission RUG category for payment for the initial five day Medicare MDS in collaboration with the MDS Team.

10. Establishes individual MDS schedules and coordinates assessment activities across clinical disciplines for each patient following regulatory requirements.

11. Ensures the MDS's are encoded, edited, locked and electronically transmitted within the required time frames.

12. Initiates and coordinates patient discharge plan upon admission to the facility in collaboration with the social services, admissions, clinical team, patient and family.

13. Performs a nursing physical and psychosocial MDS assessment on all patients and reassessments as per the MDS scheduled requirements unless these are assigned to other clinical disciplines for completion.

14. Determines the RUG categories of Medicare payments for patients based upon the MDS assessments and in collaboration with the MDS team.

15. Reviews and sends the MDS scores and RUGs categories to the billing office within the required time frames.

16. Identifies cost variances and recommends cost controls related to resource utilization.

17. Demonstrates ability to directly perform treatments and provide services to the level of licensure.

18. Knowledge of medication and their correct administration based on age of the patient and their clinical condition.

19. Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's care.

20. Demonstrates an ability to assist physicians with procedures and performs services requiring technical and manual skills.

21. Demonstrates an ability to be flexible, organized, and function under stressful situations.

22. Treats patients and their families with respect and dignity; ensures patient confidentiality and privacy.

23. Maintains a good working relationship both with all departments and with contacts from referring facilities and agencies.

24. Coordinates and supervises Medicare and other MDS patient care activities as necessary to maximize resource utilization.

25. Attends weekly meetings to include LOC, Medicare staff meetings, therapy meetings, and care plan meetings for residents.

26. Coordinates care planning with Assessment Nursing for skilled residents.

27. Prepares requests for issuance of denial letters on admission and readmission.

28. Works closely with DON to ensure the highest level of care for all residents.

29. Assists in the admissions process as assigned by Supervisor.

30. Assists with discharging skilled residents.

31. Makes rounds of Medicare patients at least daily.

32. Sees that supplies are available in proper quantities, that equipment is available in good condition and that personnel using such supplies and equipment know where such are to be found and know the proper care and use.

33. Sees that all personnel are oriented to the duties assigned to them to meet the required MDS documentation requirements.

34. Conducts in-services as requested.

35. Notifies the physician, resident and family/POA of any new or unusual findings as indicated.

36. Practices within the scope and guidelines of the Board of Nurse Examiners (BNE).

37. Performs other duties as assigned by Supervisor.

Professional Requirements:

1. Adheres to dress code, appearance is neat and clean.

2. Completes annual educational requirements per policy.

3. Maintains regulatory requirements.

4. Reports to work on time and as scheduled. Completes work within designated time.

5. Wears identification while on duty.

6. Completes in-services and returns to work in timely manner.

7. Attends specified staff meetings, reads and returns all information required by immediate supervisor.

Language Skills:

1. Ability to read and communicate effectively in English.

2. Additional languages preferred.

Skills:

1. Current nursing assessment knowledge

2. Ability to develop Plans of Care

3. Ability to document patient care outcomes

4. Basic computer knowledge

5. Ability to organize and implement MDS and plan of care schedules

Physical Requirements:

Ability to drive and possess a valid/current drivers license.

Physical Demands:

Use the percentages range as follows:

Requires full range of body motion including:

Job Location:M