Position Summary
The primary function of this position is to conduct and coordinate the development and accurate completion of the resident assessment and care plan process in compliance with all federal, state and local guidelines which govern the facility, and, as directed by the Director of Nursing Services and/or the Administrator so as to ensure each resident’s individual needs are identified and addressed accordingly through the assessment process.
General Purpose
The general purpose of the RN Staff Nurse-MDS Coordinator is to coordinate the entire RAI process ensuring the accuracy, timeliness, and completion of the MDS, CAA’s, and interdisciplinary care plan in accordance with all federal, state, and certification guidelines. This includes oversight of the activities performed by the LPN Staff Nurse-MDS Coordinator. Additionally, obtain insurance pre-certifications and re-certifications, coordinate managed care services and monitoring of the facility CMI (case mix index).
Role Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and abilities necessary to perform the position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Position Responsibilities
Specific responsibilities of the position include, but are not limited to, the following:
- Conduct and coordinate the development and accurate completion of the resident assessment and care planning process, including the implementation of CAA’s.
- Coordinates scheduling of OBRA and Medicare/managed care assessments, entry/re-entry records, and care plan reviews in accordance with the most recent regulatory guidelines.
- Assists the RN Case Manager, Director of Nursing to ensure all documentation in the clinical record meets federal, state, and certification guidelines.
- Scheduling of all Medicare Part A and/or Managed Care MDS assessments in accordance with applicable RAI and state guidelines.
- Coordinates scheduling of care plan conference following the RAI manual and any applicable state guidelines.
- Work with all staff so as to enhance reimbursement, as applicable, through documentation of care and services provided.
- Work as part of the overall facility team to ensure documentation of care and services is appropriate and supports reimbursement.
- Coordinates the facility resident review process held weekly.
- Coordinates the facility review of claims for “triple check” for skilled residents monthly.
- Performs random audits of skilled resident records for presence of daily documentation to support skilled services received.
- Inform residents, responsible parties and staff of Medicare/managed care coverage status through appropriate documentation in accordance with all federal, state and facility guidelines. Provides updates as necessary.
- Works with Community Health Choice (CHC) case managers for Managed Medicaid providers.
- Participate in committees as directed.
- Adheres to the established facilities policies related to infection control and reducing the potential spread of infection.
- Works cooperatively as part of the health care team to evaluate and revise current practices, policies and procedures.
- Maintains and promotes relationships with residents, visitors, and other staff members, and government regulators by presenting a professional appearance and positive attitude.
- Understands, complies with, and promotes all rules regarding resident rights and confidentiality.
- Attends and participates in orientation, training efforts, educational activities, in-service functions, and staff meetings.
- Understands and follows safety and sanitation rules, practices safety in provision of services, and promptly reports any hazards or violations to a supervisor.
- Performs additional functions or duties, as assigned by the supervisor.
Essential Knowledge, Skills and Ability
Education/Certifications/Experience
- EDUCATION: High school diploma or GED is required. Associate’s or Bachelor’s degree in Nursing preferred.
- LICENSURE/CERTIFICATION: Current RN license is required and must be in good standing with the Commonwealth of Pennsylvania. Possession of a current Basic Life Support for Health Care Providers CPR certificate.
- EXPERIENCE: Previous experience in completion of Resident Minimum Data Sets and Care planning required. Basic computer knowledge is essential.
Knowledge
- CUSTOMER AND PERSONAL SERVICE: Knowledge of principles and processes for providing excellent customer and personal services.
- ENGLISH LANGUAGE: Must have the ability to read, write, and follow oral and written directions at a level necessary to accomplish the job.
- PSYCHOLOGY: Recognizing and being sensitive to resident and family concerns, stressors during time of admission or financial difficulty.
- SAFETY AND SECURITY: Knowledge of relevant equipment, policies, procedures, and strategies to promote effective local, state, or national security operations for the protection of staff and residents, data, and the Facility as a whole.
- MATHEMATICS: Ability to perform basic mathematics.
Skills/Abilities
- ACTIVE LISTENING: Ability to give full attention to what others are saying. Taking time to understand the points being made, and asking questions, if appropriate. Ability to hear and respond to resident call bells.
- COMMUNICATION: Ability to communicate effectively across the organization. Includes the ability to read, comprehend, and interpret documents such as safety rules and procedure manuals and the aptitude to write routine reports and correspondence. Ability to speak effectively and be understood by others.
- MONITORING: Assessing performance of self, other individuals, or the Facility to make improvements or take corrective action.
- CRITICAL THINKING: Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
- PROBLEM SENSITIVITY: Ability to tell when something is wrong or is likely to go wrong. It includes recognizing and solving problems.
- ORGANIZING, PLANNING & PRIORITIZING WORK: Ability to develop plans in order to organize, set priorities, and accomplish daily duties.
- JUDGMENT AND DECISION MAKING: Considering the relative costs and benefits of potential actions to choose the most appropriate one.
- TEAMWORK: Ability to work well with supervisors, peers, and subordinates to achieve goals. Readily gives and receives help and values the contribution of teammates.
- SERVICE ORIENTATION: Actively looking for new ways to help others.
- ATTENTION TO DETAIL: Being careful and thorough in completing work-related tasks.
- STATIC STRENGTH: Ability to exert repetitive muscle force to lift, push, pull, or carry objects up to 50 pounds.
- NEAR VISION: Ability to see details at a close range.
- EMOTIONAL STABILITY: Ability to cope with the stresses of the environment.
- DEPENDABILITY: Reliable, responsible, and dependable, while fulfilling obligations. Must be capable of maintaining regular attendance.
- INTEGRITY: Ability to be an honest and ethical employee while exercising both patience and tact and complying with the Facility’s policies and procedures.
- TECHNICAL: Ability to understand equipment function and operation such as lifting equipment, oxygen usage, and other medical equipment. Ability to use computer technology as trained.