Housekeeping

Job Summary:The resident assessment /care plan coordinator is responsible for the contamination 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.The primary purpose of the restorative nurse position is to perform restorative nursing programs that maximize the resident's existing abilities,emphasize independence instead of dependence and minimize the negative effects of disability with an attitude of realistic optimism under the supervision of a restorative nurse.

Delegation of Authority: As the MDS/Restorative Nurse you are delegated the administrative authority,responsibility, and accountability necessary for carrying out your assigned duties.

Essential Responsibilities and Duties:

• Prior to or at the time of admission,review resident records for skilled service meeting the guidelines for Medicare coverage,as appropriate
• Provide Medicare charting Guidelines to nursing staff, as appropriate
• Manage Medicare A Certification/Re-Certification process per CMS guidelines and timeframe
• Coordinate the Resident Assessment Instrument(RAI)process including completion of a accurate Minimum Data Set(MDS)and development of the interdisciplinary Plan of Care(CP)
• Review records for diagnoses and complete ICD-9 Coding and sequencing for payer type, as needed
• Prior to look-back period, meet with IDT to review resident programming and documentation requirements to msximize reimbursement and provide an accurate picture of the care being provided to the resident
• Schedule resident for appropriate OBRA and/or Medicare PPS MDS(schedule and unscheduled)per RAI and CMS guidelines and timeframes allowed
• Work in collaboration with the Therapy Program Manager to ensure the most appropriate assessment date is utilized
• Maintain Therapy Intensity Schedule COT binder and review daily with Therapy Program Manager-scheduling COT OMRA's as necessary
• Perform ongoing evaluation from pre-admission through discharge to ensure an appropriate reimbursement level for each resident
• Review medical records, care plans,charting to ensure documentation supports care provided and reimbursement level
• Complete appropriate MDS interviews following designated script on or to the ARD within the window,document time/date and staffmember completing the (include tyoe) interview in the medical record on the day it occurred when indicated
• At minimum, complete the sections assigned to the MDS Coordinator per facility processes(A,B,I,J0100,J1550,K0510A&B,K0700,L.N.O0100-O0450,0600-0700,V,X,Z)
• Strive to complete MDS section within 2 working days after ARD
• MDS Nurse to complete CAA's for Delirium,Visual,Feeding Tubes,Dehydration,Dental,Psychotropic Drug and Pain
• Oversight of all disciplines involved n 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
• Complete other sections of the MDS when incomplete to prevent late closure
• During '7-day encoding period' after MDS completion, upload MDS data to eHDS prior to state transmission for review with eflags, Quality Measures and make corrections as needed during '7-day encoding period' after corrections are completed,re-submit to eHDS
• Utilize all available tools to validate the accurateness of the MDS
• Signs MDS sections for accurateness-RN must sign for completeness
• Maintain supportive documentation packet for each OBRA and Medicare PPS for validation o RUG
• Audit MDS for validation of RUG- audit should not be completed by the nurse completing the MDS
• Create submission files and transmit MDS data timely to the State/CMS repository - no later than 14 days after the completion of MDS/PPS assessments and no later than 7 days after completion of Entry/Death in Facility Tracking
• Review Validation Report for warnings and rejections,responding as appropriate, and maintain transmission Validation Reports
• Review Assessments Due Report and PPS Assessment Due Report 2-3 times a week to track assessments that are due
• Complete and provide MDS,PPS,and CP Calendars to all disciplines involved in MDS and CP
• Review telephine orders and update care plans problems,goals and approaches as necessary
• Participate in Morning Meeting review to monitor for changes in resident condition
• Perform modifications of assessments in accordance with CMS Policy
• Participate in Claims Triple check Procedure
• Ensure Care Plans Conference Process is followed by all disciplines
• Ensure Care Plan Update Process is followed by all disciplines
• Ensure End of Month Billing Process is completed timely
• Maintain Benefits Exhaust Log and fax to designated biller each month
• Participates in assigned meetings as deemed necessary
• Ensure Medicare Meeting Process is followed by all disciplines
• Attends in-service raining and other educational programs as directed or authorized
• Performs all job duties in a manner that ensures that confidential information and resident rights are protected at all times
• Responsible for facilitating,preparing,implementing appropriate procedures to meet the needs ethically of the reimbursement entitles surveying the facility
• Complies with established standards described in facility policies and procedures,code of conduct,corporate compliance plan,employee handbook and other company documents and publications
• Performs other duties or functions as directed
• Develop and maintain restorative care standards
• Assist in standardizing the methods in which restorative care will be accomplished
• Maintain a reference library of written restorative care material,laws,etc. necessary for complying with current standards and regulations,and that will provide assistance in maintaining quality resident care
• Review restorative care policies,procedures,manuals ,job descriptions, etc. at least annually and participate in making recommended changes
  
  
  

Education Requirements

Must posses, as minimum,a Nursing Degree from an accredited college or university

Specific Requirements

Must posses a current,unencumbered,active license to practice as a Registered Nurse in this state,must be able to read,write,speak and understand the English language,must posses the ability to make independent decisions when circumstances warrant such action,must posses the ability to deal tactfully with personnel,residents,family members,visitors, government agencies/personnel and the general public,must be knowledgeable of nursing and medical practices and procedure,as well as laws,regulations,and guidelines that pertain to long-term care,must posses leadership and supervisory ability and the willingness to work harmoniously with and supervise other personnel.must posses the ability to plan,organize,develop,implement the programs ,goals,objectives,policies and procedures,etc.that are necessary for providing quality care,must have patience,tact,a cheerful disposition and enthusiasm, as well as the willingness to handle difficult residents,must be willing to seek out new methods and principles and be willing to incorporate them into exiting nurses practices,must be able to relate information concerning a resident's condition,must not pose a direct threat to the health or safety of others individuals in the workplace