MDS FULLTIME

DEPARTMENT: Nursing
REPORTS TO: Director of Nursing
POSITION SUMMARY:

The essential functions of the job for a MDS Coordinator/Registered Nurse require, and may be amended from time to time at the sole discretion of Windsor Health Care, LLC to include, but are not limited to the following:

•    Must possess a valid RN license, in good standing in accordance with laws of this state, from an approved NJ Nursing School of Nursing.
•    Comprehensive knowledge of Medicare reimbursement, Medicaid and third party payor regulations is required.
•    Experience with MDS completion, reimbursement, clinical resource utilization and/or case management is required.
•    Comply with standards of business conduct in accordance with federal, state and local health and regulatory standards and guidelines, as applicable.
•    Must possess, at a minimum, of a high school diploma and/or higher education; a GED and at least three (3) years of experience in the healthcare field and/or related industry.
•    Must be able to work well with peers in a congenial work environment, and above all, maintain the utmost compassion and dignity to the residents and adhere to the Resident Bill of Rights.
•    Must be able to work beyond normal working hours; on weekends, as well as holidays, to the extent necessary. On-call status is a function of the job and employee understands, agrees to, and acknowledges that schedule flexibility is for the betterment of the residents and that the MDS Coordinator will make themselves available, as needed, to ensure proper staffing levels.
•    In exigent circumstances, the employee may be subject to call back during emergency conditions (e.g., severe weather,
evacuation, temporary staffing shortages, etc.).
•    Must adhere to Windsor Health Care, LLC's attendance policies and follow the terms and conditions of employment as set forth in the Employee Handbook.
•    Must be able to read, write, speak and understand English.
•    Must maintain the highest standards in caring and servicing the needs of the residents and residents' family members and loves ones.
•    Must adhere to all facility policies and procedures.
RESPONSIBILITIES/ACCOUNTABILITIES:
•    Assesses and determines the level of care on all new admissions;
•    Assumes responsibility for all level of care changes within the facility;
•    Generates appropriate forms to complete level of acuity change and sends forms to the appropriate agency for processing, as required by state law;
•    Participates in communicating changes of acuity level of residents to the Medical Director, Administrator, Admission Director and D.O.N.;
•    Attends daily admission meeting, as needed;
•    Coordinates interdisciplinary participation in completing the MDS and ensures completion of MDS within days of admission according to Medicare schedule;
•    Completes the Resident Assessment Protocol (RAP) form within guidelines;
•    Participates in facility’s and/or nursing committees as requested;
•    Maintains accurate records of resident assessments which are due and communicates with other departments;
•    Coordinates the completion of the interdisciplinary plan of care. Facilitator of the care planning team. Notifies all disciplines of the care planning schedule;
•    Assumes responsibility for monitoring and reviewing, and transmitting resident data as part of the electronic transmission of MDS;
•    Performs any work assignments as may be assigned;
•    Teaches staff to enhance their skill level in providing accurate, timely, and appropriate information into the resident assessment system;
•    Maintains all operational documentation as indicated by facility management;
•    Concerns his/herself with the safety of all facility residents in order to minimize the potential for fire and accidents. Also ensures that the facility adheres to all legal, safety, health, fire and sanitation codes by being familiar with his/her role in carrying out the facility’s fire, safety and disaster plans and by being familiar with current MSDS;
•    Ensures that residents and families receive the highest quality of service in a caring and compassionate atmosphere which recognizes the individuals’ needs and rights;
•    Revenue Optimization:
o    Tracks Medicare residents to determine continued and appropriate Medicare eligibility and benefit period by predicting subsequent RUGs categories;
o    Reviews pre-admission intake information to predict RUGs level for Medicare residents and to identify potential cost outliners and communicates findings to Administrator/care team;
o    Performs concurrent MDS review to insure appropriate RUGs category is achieved through the capture of appropriate clinical information. Identifies opportunities to enhance reimbursement;
o    Participates in the interdisciplinary team process to communicate opportunities facilitate efficient and effective care plan development and management. Communicates with care team regarding practitioner orders, care plans and changes in condition;
o    Collaborates with Business Office to review RUGs reports and identify RUGs categorization.
•    MDS Schedule and Tracking:
o    Ensures the accurate and timely completion of all MDS assessments including 5, 14, 60, 90 day, quarterly, annual and significant change;
o    Maintains an accurate schedule of all MDS assessments to include the proper reference dates throughout the resident’s stay;
o    Completes the admission and discharge tracking form and maintains tracking system for admission/re-entry/discharge.
•    Data Entry, Verification, Locking and Transmission:
o    Responsible for the data entry function to assure accurate data entry and electronic transmission of MDS assessments;
o    Verifies accuracy of MDS prior to locking;
o    Verifies electronic transmission of MDS and maintains appropriate records;
o    MDS data entry and transmission function includes:
    Keying all information from each completed hard copy MDS into Buckingham & Brentwood Care Center electronic MDS record,
    Locking each MDS, transmitting via the Internet all completed MDS to the State on a monthly basis,
•    Billing:
o    Provides computer printout of resident specific RUGs category to Business Office at the end of the month.
•    Quality Control:
o    Reviews initial and final validation and error reports;
o    Conducts regular audit of MDS process;
o    Audits medical record documentation to validate that the documentation supports the MDS coding;
o    Assesses and evaluates the outcomes of the MDS process to determine additional training, education and monitoring needs.
•    Education and Resource:
o    Serves as the facility resource for MDS/RUGs;
o    Provides education to the interdisciplinary team as appropriate;
o    Instructs Facility staff in terminology, language, and format that is required by MDS;
o    Communicates with Facility Administrator, interdisciplinary team and Business Office regarding any changes in PPS;
o    Trains backup personnel for MDS’s;
o    Identifies areas of educational need.
•    Other Duties
o    Assists in the preparation of all requests from appropriate State and/or federal regulatory agencies or agents regarding payment of services (reconsideration, denials appeals, etc.);
o    Maintains all reports and transmission data in a systematic format and stores in a safe, locked area;
o    Maintains a current and comprehensive knowledge of MDS and Medicare (PPS) reimbursement;
o    Implements all required forms, procedures and processes relative to job responsibilities;
•    Adhere to all facility policies and procedures;
•    Comply with standards of business conduct, and state/federal regulations and guidelines;
•    Follow appropriate safety and hygiene measures at all times to protect residents and yourself;
•    Attend care plan meetings of assigned residents;
•    Participate QAPI or facility assessment activities as needed, such as carrying out duties assigned as part of a performance committee;
•    As a condition of employment, complete all assigned training and skills competency;
•    Participate in all life safety and emergency drills and trainings;
•    Fulfill responsibilities as assigned during implementation or activation of the facility’s emergency plan;
•    User proper lifting and body mechanics while delivering care to residents;
•    Maintain confidentiality of protected health information, including verbal, written, and electronic communications;
•    Report non-compliance with policies, procedures, regulations, or breaches in confidentiality to appropriate personnel;
•    Report any retaliation to the Human Resource Director and to the Compliance Officer;
•    Report any allegations of abuse, neglect, misappropriation of property, exploitation, or mistreatment of residents to the supervisor;
•    Fulfill individual responsibility to report any suspicion of a crime to law enforcement and state agency;
•    Protect residents from abuse, and cooperate with all investigations;
•    Report any occupational exposures to blood, body fluids, infectious materials, and/or hazardous chemicals in accordance with facility policy;
•    Report any workplace injuries and illnesses immediately to supervisor;
•    Performs other related duties as requested.
ANNUAL HEALTH REQUIREMENTS:
•    Must provide annual verification of a negative TB skin test.
PHYSICAL AND SENSORY REQUIRMENTS:
(With or Without the Aid of Mechanical Devices)
•    Must be able to move intermittently throughout the workday.
•    Must be able to cope with the mental and emotional stress of the position.
•    Must be able to see and hear or use prosthetics that will enable these senses to function adequately to ensure that the requirements of this position can be fully met.
•    Must meet the general health requirements set forth by the policies of this facility, which include a medical and physical examination.
•    Must be able to relate to and work with the ill, disabled, elderly, emotionally upset, and, at times, agitated residents.
•    Must be able to push, pull, move, and/or lift a minimum of 25 pounds to a minimum height of 5 feet and be able to push, pull, move, and/or carry such weight a minimum distance of 50 feet.
•    May be necessary to assist in the evacuation of residents during emergency situations.