What are the responsibilities and job description for the MDS Program Director RN position at Symphony Care Network?
Job Description
Job Description
Description :
To oversee and coordinate the resident assessment process including, but not limited to, training of staff in the assessment process, coordinating schedules for completion of the MDS forms on admission, quarterly and annually on all residents.
Coordinates assessment completion in accordance with OBRA and Medicare guidelines
Participates in guest care conferences, reviews guests for significant changes on an on-going basis to insure proper care planning for guests.
Keeps all staff advised on changes in MDS system
Promotes an optimal level of wellness for each guest in the facility.
Maintains compliance with all policies and procedures of the facility as well as State and Federal Regulations.
Acts as facility PPS program monitor
QUALIFICATIONS :
Licensed R.N. with previous management experience in a long term care facility.
Knowledge of State and Federal Regulations.
MDS certification preferred
MDS experience preferred
Requirements :
The duties of the position may include, but are not limited to the following areas :
MDS Assessment
Schedules the MDS process for all residents as mandated by State and Federal Regulations.
Oversees the timely completion of all MDS assessments and forms.
Monitors residents for significant change and generates the appropriate assessment and completion of forms.
Face Sheet completion with diagnosis prioritized. Ensures priority diagnosis is communicated to the team
Has working knowledge of the RAI manual and updates released
Understands and schedules OBRA required assessment in accordance with regulations
Understands and scheduled Medicare (PPS) assessments in accordance with regulations
Understands and scheduled unscheduled PPS and OBRA assessments when identified
as applicable to a guest’s condition.
Performs discharge assessments as required
Performs entry tracking records as required
Ensures interdisciplinary completion of the CAA process
Ensure CAA summaries contain risk / benefit analysis as necessary
Ensures therapy log is attached to each completed PPS MDS verifying therapy minutes provided.
Submits all required MDSs timely
Captures required signatures for MDS completion and files the MDS in accordance with regulation and facility procedure.
Accesses and shares CASPER reports with Director of Health Services and General Manager
Understands and applies appropriate reasoning for selection of assessment reference date
Initiates certifications and tracks the need for recertification
Able to contact MDS help desk or QTSO for technical issues
Medicare Meetings
Attends weekly Medicare meetings
Discusses current ADL scores for each guest based on review of available documentation
Discusses current RUG level
Able to articulate reason for coverage and estimated end of coverage for guests based on knowledge of Medicare skill criteria
Notice of Noncoverage
Evaluates the need for administering notice of noncoverage based on Medicare criteria
Administers notice of noncoverage and explains guest appeal rights
Ensures the correct notice is provided based on services / insurance used for coverage
Administers notice of exclusion from Medicare benefits when applicable
Understands and assists in the advance beneficiary notice process
Expedited Appeals
Immediately notifies Director of Health Services, General Manager, and Corporate Consultant of receiving notice of expedited appeal
Coordinates expedited appeal
Drafts detailed notice of noncoverage and provides a copy to the guest and QIO.
Understands Medicare audit process
Survey Participation
Shares in the duties / responsibilities with the Director of Health Care Services as delegated.
Creates QI / QM reports routinely and provides copies to Director of health Services and general manager
Makes rounds as instructed by the director of health Services
Keeps facility Roster current and provides a copy to Director of Health Services weekly
Reviews facility census and conditions form for accuracy. Provides a copy weekly to Director of Health Services and General Manager
Communication
Collaborates with all departments.
Review PPS reports and communicates inaccuracies to billing department, facility
directors, and corporate consultant
Communicates changes in RUG scores or corrections made to MDSs to billing.
Responsible for communicating default rates immediately to GM / DHS.
Care Planning
Reviews all resident care plans on a regular basis to insure a proper plan of care is in place.
Updates care plans upon change in condition
Ensure current plan of care reflect current condition of the guest
Care Conference
Attends care conferences for families.
Acts as nursing representative for care conference
Discharge Planning
Reviews Medicare skill criteria continuously and communicates changes to social service and team for discharge planning as appropriate.
Assists social service in discharge planning as necessary
Ancillary Assessments
Oversees the completion of ancillary assessments (i.e. fall risk assessment, dehydration assessment, BIMS, PHQ 9, etc).
Ensure ancillary assessments are completed quarterly and with any significant change
Education
Participates in the facility in-service program to train personnel in the MDS process.
Provides education for staff on changes in MDS process
Identifies and address learning needs regarding the MDS process
Insurance
Understand criteria, documentation, and MDS requirements for several different insurances
Cost Analysis
Performs cost analysis as necessary
Therapy Meetings
Participates in monthly therapy meeting
Able to articulate RUG groups and how they were generated
Understand RUG groupers and PPS rates associated
Participates in facility analysis of unplanned discharges.
Miscellaneous
Promotes and maintains a good rapport among all departments, residents, public, and visitors.
Other related duties as assigned.
Upholds Resident Bill of Rights at all times.
Acts as supervisor for any additional MDS staff.
Acts as supervisor of nursing staff
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