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MDS Coordinator

JOB PURPOSE: Coordination of all required Resident Assessment Instruments per state and federal guidelines to ensure timely completion.?


ESSENTIAL DUTIES AND RESPONSIBILITIES:


Resident Assessment




  • Coordination of all required R.A.I. per state and federal regulations to ensure timely completion. Timely transmission of all required R.A.I. per state and federal regulations.


  • Maintenance of R.A.I. calendar, accessible to members of the Interdisciplinary Team (IDT), which provides clear, concise, up to date information on completion deadlines for each phase of the R.A.I. process for each applicable resident.


  • Monitoring of ancillary department sections of the RAI for timely completion, including notification of the individual departments if deadlines are in danger of not being met.


  • Prompt notification of IDT members when a change of condition RAI is initiated. Facilitates and maintains smooth, seamless, timely communication with all members of the IDT regarding residents Medicare status and RUG categories.


  • Maintaining a current knowledge base regarding state and federal regulations relative to the RAI process and PPS.


  • Notification to the DNS and Administrator of any barriers to timely, accurate completion and transmission of RAI in order to prevent missing deadlines.


  • Active participation in the development of a comprehensive, individualized, interdisciplinary plan of care for each resident. Coordinating and facilitating interdisciplinary Resident Care Plan Conferences to meet state and federal regulations. Ensuring that the resident and responsible party receives written invitation and notification of the meeting, specifying time and place.


  • Insure care plans are updated, and accelerated to reflect an interdisciplinary approach to the residents' changing needs.



Medicare Utilization Review




  • Review of each Medicare resident's case on the day of admission to insure appropriateness of Medicare coverage.


  • Active interaction with IDT in Medicare meetings to evaluate each resident's status and needs relative to Medicare skilled needs and potential for RUG category changes.


  • Reviewing Medicare documentation to insure that:


    • Residents receive the care and services they need in a timely, cost-effective manner.


    • Change of condition RAI are initiated when appropriate.


    • Chart documentation and c.n.a flow sheets reflect the need for the care and services the resident receives.


    • Medicare coverage si discontinued when resident no longer meets criteria.




  • Consults routinely with the Clinical Case Manager assigned to each resident regarding the resident's Medicare coverage status.


  • Must keep PPS and OBRA calendar current.


  • Must utilize approved Wingate documentation forms and schedule notification forms as determined by Regional MDS / Medicare Coordinators.


  • Must be in compliance with MDS / Medicare protocols and policies.


  • All OBRA MDS's nursing sections are completed by MDS.


  • All PPS Assessments nursing sections are completed by the MDS.


  • Diagnosis and ICD-10 coding is done for all Admissions/Readmissions by MDS.


  • Committed to working with residents and families to develop and implement strategies that promote person-centered care.


  • Applies "5 Star" customer service approach in all aspects of job.


  • Actively supports Wingate's commitment to providing "5 Star" service on all quality objectives, with an emphasis on continual improvement.


  • Adheres to all company policies, procedures, and standards of conduct.


  • Reports to the appropriate managers any known or suspected violations of policy and procedures, regulations or standards of conduct.


  • Performs additional duties as assigned.


  • Participates in Medicare and Managed Care Triple Check.



POSITION REQUIREMENTS:




  • Graduate of an approved nursing school. Current Nurse license in this state.


  • Previous experience with geriatric patients is essential.


  • Must have a thorough knowledge of RAI process as it pertains to OBRA and Medicare regulations.


  • Strong organizational ability.


  • Strong written and oral communication skills.


  • Strong computer skills.



SUPERIVISON OF OTHERS: None


AMERICANS WITH DISABILITY SPECIFICATIONS


PHYSICAL DEMANDS 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.


WORK ENVIRONMENT Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


While performing the duties of this job, the employee is not exposed to weather conditions.


The noise level in the work environment is usually moderate.


Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
 

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