MDS

City View Multi Care Center -

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. ESSENTIAL JOB FUNCTIONS : 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 32. Ensure Care Plan Update Process is followed by all disciplines 33. Ensure End of Month Billing Process is completed timely 34. Maintain Benefits Exhaust Log and fax to designated biller each month 35. Participates in assigned meetings as deemed necessary 36. Ensure Medicare Meeting Process is followed by all disciplines 37. Attends in-service training and other educational programs as directed or authorized. 38. Performs all job duties in a manner that ensures that confidential information and residents rights are protected at all times 39. Responsible for facilitating, preparing, implementing appropriate procedures to meet the needs ethically of the reimbursement entities surveying the facility 40. Complies with established standards described in facility policies and procedures, code of conduct, corporate compliance plan, employee handbook and other company documents and publications. 41. Performs other duties or functions as directed. 42. Monitor Point Click Care (Point of Care) documentation daily and report non-compliance to the DON and / or designee. Complete POC documentation during the ARD period and PRN. 43. Quarterly Review of the HFS Roster (IL) / Quarterly Review of the Time Weighted Report (IN) 44. Coordination of the HFS Audit Survey Process (Surveys are random at this time) IL / Coordination of the Myers and Stauffer’s MDS Audit Survey Process (Surveys are Scheduled and are not random) IN 45. Coordination of the MDS Focused Surveys (IL and IN) 46. Coordinate of data collection for the ADR Process (Additional Documentation Requests) for Medicare Part A and B as well as Managed Care. KNOWLEDGE / SKILLS & ABILITIES : 1. Must possess a current, unencumbered, active license to practice as a Registered Nurse or Licensed Practical Nurse in this state. 2. Must be able to read, write, speak and understand the English language. 3. Must possess the ability to make independent decisions when circumstances warrant such action. 4. Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies / personnel, and the general public. 5. Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care. 6. Must possess leadership and supervisory ability and the willingness to work harmoniously with and supervise other personnel. 7. Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies and procedures, etc. that are necessary for providing quality care. 8. Must have patience, tact, a cheerful disposition and enthusiasm, as well as the willingness to handle difficult residents. 9. Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices. 10. Must be able to relate information concerning a resident’s conditions. 11. Must not pose a direct threat to the health or safety of others individuals in the workplace. EDUCATION / EXPERIENCE : Must possess, as a minimum, a Nursing Degree from an accredited college or university. Optional : Certification programs for MDS Coordinators are available through the American Association of Nurse Assessment Coordinators (AANAC). The AANAC offers credentials such as Resident Assessment Coordinator – Certified and Certified Nurse Executive. In order to PHYSICAL DEMANDS : 1. Must be able to move intermittently throughout the workday. 2. Must be able to move intermittently throughout the workday. 3. Must be able to speak and write the English language in an understandable manner. 4. Must be able to cope with the mental and emotional stress of the position. 5. 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. 6. Must meet the general health requirements set forth by the policies of this facility which include a medical and physical examination. 7. Must be able to relate to and work with the ill, disabled, elderly, emotionally upset, at times hostile people within the facility. 8. Must be able to lift a minimum of 25 pounds; must be able to push, pull and / or move a minimum of 50 pounds and be able to push, pull, and / or move such weight a minimum distance of 10 feet. 9. May be necessary to assist in the evacuation of residents during emergency situations. WORK ENVIRONMENT : 1. Works in office area(s) as well as throughout the nursing service area (i.e., drug rooms, nurses’ stations, resident rooms, etc.). 2. Moves intermittently during working hours. 3. Works in office area(s) as well as throughout the nursing service area (i.e., drug rooms, nurses’ stations, resident rooms, etc.). 4. Moves intermittently during working hours. 5. Is subject to frequent interruptions. 6. Is involved with residents, personnel, visitors, government agencies / personnel, etc. under all conditions and circumstances 7. Is subject to hostile and emotionally upset residents, family members, personnel, and visitors. 8. Communicates with the medical staff, nursing personnel, and other department supervisors. 9. Works beyond normal working hours and on weekends and holidays when necessary. 10. Is subject to call-back during emergency conditions (e.g., severe weather, evacuation, post disaster, etc.). 11. Is involved in community / civic health matters / projects as appropriate. 12. Attends and participates in continuing educational programs. 13. Is subject to injury from falls, burns from equipment, odors, etc., throughout the work day, as well as to reactions from dust, disinfectants, tobacco smoke, and other air contaminants. 14. Is subject to exposure to infectious waste, diseases, conditions, etc., including TB and the AIDS and Hepatitis B viruses. 15. May be subject to the handling of and exposure to hazardous chemicals. 16. Maintains a liaison with the residents, their families, support departments, etc., to adequately plan for the resident’s needs. JOB PERFORMANCE CRITERIA

• Professional : In all behaviors, presentation of oneself and dress (as appropriate to job)
• Respectful : To all residents, all employees (supervisory and non supervisory), all visitors and all callers
• Efficient : In management of work hours, assigned projects, duties, and responsibilities
• Productive : In completion of assigned projects, duties, and responsibilities with required timeframe
• Protect Confidentiality Of all data accessible to this position
• Accountable To supervisory and administrative staff in adherence to and implementation of Human Resources policies / procedures, department operating standards, and federal, state, and local regulations I have read this job description and fully understand the requirements set forth therein. I hereby accept the position of the Resident Assessment / Care Plan Coordinator and agree to perform the identified essential functions in a safe manner and in accordance with the facility’s established procedures. The above job description is intended to describe the general nature and level of work required of this position. This is not meant to be an exhaustive list of all requirements, duties and skills required. This organization reserves the right to revise the essential position functions as the need arises. I understand that as a result of my employment, I may be exposed to blood, body fluids, infectious diseases, the contaminants (including tobacco smoke), and hazardous chemicals and that the facility will provide to me instructions on how to prevent and control such exposures. I understand that my employment is at-will, and thereby understand that my employment may be terminated at-will either by the facility or myself and that such notice can be made with or without notice. I have received, read and understand this job description and I am able to fulfill these responsibilities. I also understand that this is not a contract or legal document.