At Pillar of Cedar Valley Nursing and Rehabilitation, we love what we do, and have fun while we're doing it! Working with our residents is an adventure. They've led amazing lives and have the stories to prove it. Here, you'll join a community of incredible residents and a company dedicated to providing the highest quality of service and care. We value kind and compassionate care and respect our residents and staff like family.

Position Summary

The Resident Assessment/Care Plan Coordinator is responsible for the coordination of the “Resident Assessment Instrument” process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payer program requirements.

A MDS (Minimum Data Set) Coordinator/Nurse is either a Licensed Practical (LPN) or Registered Nurse (RN) that conducts federally mandated assessments of the residents at a long-term care facility. MDS Coordinators are responsible for collecting integral data and compiling it into a thorough assessment to help determine the functional capacity with appropriate plan of care and to determine the reimbursement for all payer sources in relation to the RUG-IV 66 and RUG-IV 48 system established by the Centers of Medicare and Medicaid Services.

The MDS Coordinators gather information on the facility’s current residents for MDS assessment completion requirements determined by the RAI (Resident Assessment Instrument) and include, but not limited to the resident’s physical and mental status. They assess the medical record, EMR system documentation and communicate with other healthcare teams to create applicable health care plans for their current and incoming residents. MDS Coordinators aim at promoting the emotional and physical well-being of the residents of the nursing facility. A Resident Assessment Instrument(s) (RAI) are used for collection of information from families of residents, and the residents themselves by conducting interviews, initially and as well as periodically. The resident’s nutritional requirements, cognitive ability, physical status, behavior patterns and mood and other areas are taken into account by the MDS Coordinator. Certified Nursing Assistants, Restorative Aides, Unit Nurses and other facility staff use the information derived from these MDS assessments in the formulation of care plans tailored to satisfy the requirements of individual resident needs. Such care plans are implemented and monitored by MDS Coordinators in ensuring their effectiveness. The MDS Coordinators strive to ensure that the strategies are consistent with ethical standards and Medicare/Medicaid requirements. The MDS Coordinator(s) also observe and document the pricing and effectiveness of these services.

The MDS Coordinators must also conduct new resident assessments, such as Care Area Assessments (CAA’s) to help stabilize and/or improve the practices of their health care facility. They also provide OBRA (Omnibus Reconciliation Act of 1987) assessments to ensure that the facility complies with Medicaid and Medicare standards. An MDS Coordinator is also responsible to function as the main communicator post resident admission/re-admission between the Insurance/Managed Care Providers to provide a review of the plan of care and to obtain re-authorizations for ongoing TX/Services.

Job Description

1. Prior to or at the time of admission, review resident records for skilled services meeting the guidelines for Medicare coverage, as appropriate

2. Provide Medicare Charting Guidelines to nursing staff, as appropriate

3. Manage Medicare A Certification / Re-Certification process per CMS guidelines and timeframes

4. Coordinate the Resident Assessment Instrument (RAI) process including completion of an accurate Minimum Data Set (MDS) and development of the interdisciplinary Plan of Care (CP)

5. Review records for diagnoses and complete ICD-9 Coding (ICD-10 as of 10/1/15) and sequencing for payer type, as needed

6. Prior to look-back period, meet with IDT to review resident programming and documentation requirements to maximize reimbursement and provide an accurate picture of the care being provided to the resident

7. Schedule resident for appropriate OBRA and/or Medicare PPS MDS (scheduled and unscheduled), per RAI and CMS guidelines and timeframes allowed

8. Work in collaboration with the Therapy Program Manager to ensure the most appropriate assessment date is utilized

9. Maintain Therapy Intensity Schedule COT binder and review daily with Therapy Program Manager – scheduling COT OMRA’s as necessary

10. Perform ongoing evaluation from pre-admission through discharge to ensure an appropriate reimbursement level for each resident.

11. Reviews medical records, care plans, charting to ensure documentation supports care provided and reimbursement level.

12. Complete appropriate MDS interviews following designated script on or prior to the ARD within the window, document time/date and staff member completing the (include type) interview in the medical record on the day it occurred when indicated

13. At minimum, complete the sections assigned to the MDS Coordinator per facility processes (A, B, G (IN only), H (IN only), I, J, K0510A&B, K0700, L, M, N, O0100-O0450, 0600-0700, O0500 (IN only), P (IN only), S (IL only) V, X, Z)

14. Strive to complete MDS sections within 2 working days after ARD

15. MDS Nurse to complete CAA’s for Delirium, Visual, ADL (IN only), Urinary Incontinence and Urinary Catheter (IN only), Falls, Feeding Tubes, Dehydration, Dental, Pressure Ulcer, Psychotropic Drug, Restraints (IN only) and Pain

16. Oversight of all disciplines involved in the MDS process to strive to complete MDS, CAA’s and CP within 2 working days after the ARD, the exception is preparing for Medicare billing which may reduce completion time to day after ARD.

17. Complete other sections of the MDS when incomplete to prevent late closure

18. Conduct weekly CMI Meetings (IN) and RUG-IV 48 Meetings (IL)

19. Utilize all available tools to validate the accurateness of the MDS

20. Signs MDS sections for accurateness – RN must sign for completeness

21. Maintain supportive documentation packet for each OBRA and Medicare PPS MDS for validation of RUG

22. Audit MDS for validation of RUG – audit should not be completed by the nurse completing the MDS

23. Create submission files and transmit MDS data timely to the State / CMS repository – no later than 14 days after completion of MDS/PPS assessments and no later than 7 days after completion of Entry/Death in Facility Tracking

24. Review Validation Report for warnings and rejections, responding as appropriate, and maintain transmission Validation Reports

25. Review Assessment Due Report and PPS Assessments Due Report 2-3 times a week to track assessments that are due

26. Complete and provide MDS, PPS and CP Calendars to all disciplines involved in MDS and CP

27. Review telephone orders and update care plan problems, goals and approaches as necessary

28. Participate in Morning Meeting review to monitor for changes in resident condition

29. Perform modifications of assessments in accordance with CMS Policy

30. Participate in Claims Triple Check Procedure

31. Ensure Care Plan Conference Process is followed by all disciplines

2. Provide Medicare Charting Guidelines to nursing staff, as appropriate

3. Manage Medicare A Certification / Re-Certification process per CMS guidelines and timeframes

4. Coordinate the Resident Assessment Instrument (RAI) process including completion of an accurate Minimum Data Set (MDS) and development of the interdisciplinary Plan of Care (CP)

5. Review records for diagnoses and complete ICD-9 Coding (ICD-10 as of 10/1/15) and sequencing for payer type, as needed

6. Prior to look-back period, meet with IDT to review resident programming and documentation requirements to maximize reimbursement and provide an accurate picture of the care being provided to the resident

7. Schedule resident for appropriate OBRA and/or Medicare PPS MDS (scheduled and unscheduled), per RAI and CMS guidelines and timeframes allowed

8. Work in collaboration with the Therapy Program Manager to ensure the most appropriate assessment date is utilized

9. Maintain Therapy Intensity Schedule COT binder and review daily with Therapy Program Manager – scheduling COT OMRA’s as necessary

10. Perform ongoing evaluation from pre-admission through discharge to ensure an appropriate reimbursement level for each resident.

11. Reviews medical records, care plans, charting to ensure documentation supports care provided and reimbursement level.

12. Complete appropriate MDS interviews following designated script on or prior to the ARD within the window, document time/date and staff member completing the (include type) interview in the medical record on the day it occurred when indicated

13. At minimum, complete the sections assigned to the MDS Coordinator per facility processes (A, B, G (IN only), H (IN only), I, J, K0510A&B, K0700, L, M, N, O0100-O0450, 0600-0700, O0500 (IN only), P (IN only), S (IL only) V, X, Z)

14. Strive to complete MDS sections within 2 working days after ARD

15. MDS Nurse to complete CAA’s for Delirium, Visual, ADL (IN only), Urinary Incontinence and Urinary Catheter (IN only), Falls, Feeding Tubes, Dehydration, Dental, Pressure Ulcer, Psychotropic Drug, Restraints (IN only) and Pain

16. Oversight of all disciplines involved in the MDS process to strive to complete MDS, CAA’s and CP within 2 working days after the ARD, the exception is preparing for Medicare billing which may reduce completion time to day after ARD.

17. Complete other sections of the MDS when incomplete to prevent late closure

18. Conduct weekly CMI Meetings (IN) and RUG-IV 48 Meetings (IL)

19. Utilize all available tools to validate the accurateness of the MDS

20. Signs MDS sections for accurateness – RN must sign for completeness

21. Maintain supportive documentation packet for each OBRA and Medicare PPS MDS for validation of RUG

22. Audit MDS for validation of RUG – audit should not be completed by the nurse completing the MDS

23. Create submission files and transmit MDS data timely to the State / CMS repository – no later than 14 days after completion of MDS/PPS assessments and no later than 7 days after completion of Entry/Death in Facility Tracking

24. Review Validation Report for warnings and rejections, responding as appropriate, and maintain transmission Validation Reports

25. Review Assessment Due Report and PPS Assessments Due Report 2-3 times a week to track assessments that are due

26. Complete and provide MDS, PPS and CP Calendars to all disciplines involved in MDS and CP

27. Review telephone orders and update care plan problems, goals and approaches as necessary

28. Participate in Morning Meeting review to monitor for changes in resident condition

29. Perform modifications of assessments in accordance with CMS Policy

30. Participate in Claims Triple Check Procedure

31. Ensure Care Plan Conference Process is followed by all disciplines

Benefits

Competitive salary

Medical, Dental & Vision plans

Generous Vacation plan

401K retirement

Tuition Reimbursement

Paid Time Off

Positive work environment

Regular staff appreciation and recognition

Qualification

• Iowa Registered Nurse License
• Must be able to read, write, speak and understand the English language
• Demonstrated leadership
• Knowledge of Iowa Regs and the survey process

Pillar of Cedar Valley Nursing and Rehabilitation is an equal opportunity/affirmative action employer. All qualified applicants are encouraged to apply and will receive consideration for all employment; free from discrimination on the basis of race, creed, color, national origin, age, sex, pregnancy, sexual orientation, gender identity, genetic information, religion, associational preferences, status as a qualified individual with a disability, or status as a protected veteran.

 #IND