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Provides support, supervision, education, and training to assigned facilities on the resident assessment instrument (RAI) process in accordance with all laws, regulations, and standards. Responsible for the timely scheduling, completion, and transmission of Minimum Data Set (MDS) assessments.
Licensed nurse in good standing. Licensed Practical Nurse (LPN) or Licensed nurse in good standing. Registered Nurse (RN)
Acceptable background check
Over 21 years of age
MDS experience preferred
Ability to read, write, comprehend, and communicate in English, follow oral and written instructions
Must function independently and have flexibility, personal integrity and the ability to work effectively with residents, co-workers, managers, other personnel, and support agencies
Able to deal tactfully with people, both in person and over the phone
Aptitude and ability to use office machines and computer
Able to make independent decisions and possess problem-solving skills
Able to exercise discernment and make sound judgments
Knowledge of medical symbols, abbreviations, and terminology
Knowledge of nursing, medical practice, procedures, laws, regulations, and guidelines which pertain to long term care
Follow regulations to plan, schedule, and assure completion of all components of the RAI process of each resident
Utilize medical record, resident observation, resident interview, family and caregiver interviews, as well as the electronic record to assess residents.
Utilize software for completion of RAI components excluding section V, X, and Z; if RN will complete all sections
Utilize software to transmit assessments
Assure accurate completion of MDS exception of requirement of RN signature if LPN
Assure accurate completion of MDS if RN
Assure timely completion of all MDS assessments
Support Interdisciplinary Team (IDT) Team to schedule and complete care plan reviews
Complete all Care Area Assessment (CAA) that trigger and facilitate development of care plans that coordinate with CAA assessments and MDS assessments
Attend meetings to determine changes in resident status to facilitate scheduling of required assessments, to include significant change assessments
Maintains schedule of required Omnibus Budget Reconciliation Act (OBRA) and Prospective Payment System (PPS) assessments and communicate with IDT
Work with IDT to plan resident discharges from admission through discharge
Through observation of resident ad review medical record to determine appropriate diagnosis coding and enter codes into software. Review hospital discharge summary to assist with appropriate diagnosis coding.
Complete diagnosis listings, sheets, and modify diagnosis codes in relation to changes for residents
Coordinate skilled stay for residents following Medicare and Insurance guidelines and contract provisions for Managed Care Part B and C residents, and Dual eligible skilled Medicaid residents as well as private insurance
Coordinate with Regional Case Managers
Facility contact for insurance updates
Facilitate the weekly utilization review of patients on skilled services for Medicare A, and insurance patients
Review Triple Check components weekly and monthly to assure compliance with skilled services regulations and contract stipulations. Facilitate team meetings and support for RAI components, Medicare certification components, diagnosis coding components, and other areas as needed
Participate in daily meetings with facility rehabilitation coordinator to review minutes, ICD10 diagnosis coding, activities of daily living (ADL) scores, and to track change of therapy (COT) needs as well as end of therapy (EOT) needs for PPS assessments
Determine, along with IDT team, what the reason for skilled services will be and coordinate care with IDT team to assure providing these skilled services
Initiation, completion of physician/practitioner certifications as needed and assure practitioner signatures and dates are completed.
Maintain physician/practitioner signature logs
Support the ADR process and medical records as needed
Review billing process monthly with BOM to assure all required components are accurately reflected on UB-04
Gather, prepare, and present MDS related operations call information
State Specific: case mix index (CMI), level of care determination (LOCD), tracking tools, Part B logs are completed monthly. Assure access and logins needed to gather and complete required components.
Assure RAI components of regulations are in compliance
MDS exception reviews per each individual state guidelines, coordinate RAI component.
Five Star Rating System: QM's and how to access and read reports. Support clinical by communicating QM flags on an ongoing basis. Support facility team in management of QM's
Complete required in-services monthly
Complete MDS focused training as required
Project a positive attitude, treat everyone encountered with acceptance, respect and consideration, and model courteous behavior
Demonstrate a spirit of cooperation, promote harmonious working relationships, seek win-win solutions to problems and disagreements
Communicate with other departments, provide input, take an active role in problem solving, and support the final solutions
Actively participate in team development to enhance the cohesion and performance of the group
Embrace mistakes, constructive guidance and critiques as opportunities for growth and learning
Demonstrate dependability and set a good example for acceptable attendance
Attend, participate and present in-services and meetings
Pursue continuing education to obtain new ideas and broaden knowledge base, maintain credentials etc.
Support and assist in launching new policies and procedures
Show initiative and independence to complete responsibilities timely and efficiently
Flexibility to adjust own responsibilities and timetables to meet the needs of staff, department and facility
Embrace, uphold and follow rules, regulations and facility policies
Identify and communicate quality concerns, participate in quality assurance (QA), and meetings as requested
Adhere to and uphold the corporate compliance code of conduct and program
Actively and enthusiastically support the philosophy and goals of the organization
Fully participate in facility best practices protocols
Promote, support and participate in facility activity and public relations programs
Perform other tasks, as requested, to meet the goals and objectives of the organization