MDS Coordinator RN

CHI Health St. Francis was established in Grand Island Neb. in 1887. Today our hospital is a regional referral center with more than 100 physicians and more than 1100 employees working together to build a healthier community. Our goal is to provide patients with high-quality medical care close to home where they can be supported by their family friends and community. St. Francis Skilled Care is a licensed 36-bed facility providing a variety of care needs post hospitalization. In addition to our highly-trained nurses, available 24/7, we offer a full-scope of rehabilitation services, social workers to arrange for care after discharge and activities directors to help our patients reach their goals.

The primary purpose of this position is to provide management of resident care as related to the Resident Assessment Instrument (RAI) process, in accordance with federal and state regulations,and as directed by the Director of Nursing and Administrator. The MDS Coordinator is expected to have access to and follow the newest version of the RAI User’s Manual at all times. The MDS Coordinator is accountable for helping achieve the organization’s goals for positive outcomes. This is to be achieved through effective processes, monitoring, training and implementation of systems that will lead to accurate and timely MDS completion and submissions, care planning, billing practices, utilization of Resident benefits, and accurate reporting of Quality Measures.

1. Conducts initially and periodically a comprehensive, accurate, standardized, reproducible assessment of each Resident upon admission, annually (not less frequently than every 366 days) and upon significant change in status as outlined in Chapter 2 of the RAI User’s Manual.

2. Assesses every resident, using the Quarterly item set not less frequently than once every 92 days.

3. Conducts PPS Assessments, including timely opening and completion, as outlined in Chapter 2 and Chapter 6 of the RAI User’s Manual.

4. Ensures clinically accurate coding and completion of the MDS assessments.

5. Transmits data to the national repository (QIES database) in a timely manner as outlined in Chapter 2 and Chapter 5 of the RAI User’s Manual.

6. Ensures the Baseline Care Plan Summary & Medication Summary is provided to the Resident/Resident Representative (RR) by the completion of the comprehensive careplan.

7. Develops an accurate and comprehensive, person-centered care plan within 7 days of MDS/Care Area Assessment (CAA) completion, but not later than day 21 of the Resident’s stay.

8. Assigns and coordinates the work of health professionals toward accurate and timely completion of MDS assessments and care plans. Provides education to other departments that contribute to the MDS to maintain the accuracy of the assessment.

9. Communicates all MDS schedules and schedule changes either on paper or electronically (may refer the IDT team to the “MDS In Progress List” in Point Click Care (PCC) and/or communicate MDS schedules via email).

10. Ensures all OBRA MDS assessments due for completion are opened no later than the 28th calendar day of the preceding month.

11. Performs routine charting duties as required and in accordance with established documentation policies.

12. Participates or leads Utilization Review (UR) meetings, reviewing all Residents receiving skilled services covered under Medicare A FFS and Managed Care/Commercial payers. This meeting should be held at least once a week, preferably on the same day each week.

13. Participates in the Triple Check meeting to help ensure accurate HIPPS codes, days billed, and ICD-10 codes to support services are detailed on the UB-04. This meeting/process should be held monthly and comply with the elements detailed in the CHI Triple Check Policy/Guideline.

14. For managed care insurance, ensures MDS OBRA and PPS assessments required to establish a HIPPS code for billing skilled services are completed following the end of the billing month

15. Participates as a member of the nursing administrative team by assuring management duties as assigned.

16. Maintains up-to-date knowledge of current standards of nursing practice and procedures as well as laws, regulations, and guidelines that pertain to long-term care.

17. Possesses the ability to complete technical jobs as required.

18. Possesses the ability to effectively navigate the Electronic Health Record (EHR) to collect, input, and submit data necessary for the completion of the RAI process.

19. Possesses the ability to navigate other software systems, in place, to promote accuracy of MDS data (i.e. Simple LTC, ICD-10 coding software, etc.).

20. Customer Service Orientation- Possesses the ability and willingness to meet the needs of all our customers (Residents, families, facility staff, and corporate counterparts).

21. Performs case management duties for residents under a Managed Medicare, Medicaid, or commercial insurance products as assigned. (i.e. obtaining prior authorization if needed, sending concurrent reviews, and coordinating with the Managed Care organization to ensure that medically necessary services are authorized until the resident is able to safely transfer to a lower level of care).

• Current Registered Nurse (RN) license that allows you to practice in our state
• Graduate of an accredited nursing program
• Basic Life Support (BLS) required from American Heart Association
• Resident Assessment Coordinator–Certified Program (RAC-CT) within 12 months of start date