MDS RN

Job Summary

To provide and coordinate the delivery of premier resident centered health care to optimize profitability and a positive community and market presence through the coordination and implementation of clinical, regulatory and reimbursement systems so the community’s financial and clinical objectives are met or exceeded.

• Participate in the QOL, Q-Mix and Triple Check meetings conducted in the community.
• Follow systems, nursing standards and guidelines.
• Provides information and education to community team members on use of the RAI / PPS / VA processes and their correlation to resident care and reimbursement.
• Coordinate and oversee all functions of the MDS assessment process to assure accuracy and compliance with federal and state requirements.
• Timely and accurate completion of residents’ MDS assessments and care plans and take follow-up action as necessary.
• Participate in the pre‑admission process to determine potential residents’ level of care and participate in resident level of care determination upon admission.
• Support the billing schedules and procedures.
• Be familiar with residents’ condition and care needs. Follow and educate community team members on the review process and provide recommendations to address potential areas of concern/opportunity, utilizing programs and reports on various state and company generated reports.
• State Missing Assessment Report
• State Validation report
• Community Casper Report – QMs
• 5 Star
• Point Right - Fast Track, RADAR, DIA, etc.
• SimpleLTC/TMHP/Optima
• On‑hold report
• Provide education to community team members on POC documentation, change of condition alerts; late and mid‑loss ADLs to support MDS and QM data elements.
• Update an OIG binder and assist the community during OIG reviews and reconsideration process.
• Participate in clinical assignments for comprehensive reviews as part of the IDT community team.
• Follow‑up on community visit, comprehensive recommendations from regional support team members and established survey plan of corrections.
• Conduct audits of each community’s EHR/documentation systems to include but not limited to:
  • PCC MDS Module – Assessment Scheduler, ARD planner, 3.0 Batch and validation reports
  • Assessment type, submission and timing of LTCMIs, PPS, PDPM and OBRA assessments
  • MDS item set components such as: risk management, physician’s orders, interviews, section GG, POC for ADL late and mid‑loss ADL accuracy
  • Significant Change Analysis Report/24 hour Summary – run report for 72 hour period X2 to obtain a 6 day look back and review for anything that flags impacting care plans and potential significant change MDS’s
  • Physician Orders, Physician certifications/recertifications
  • Clinical Dashboard review –care plan reviews, incomplete (overdue and due) care plans, diagnosis notifications, change in condition alerts and point of care completion
  • Baseline Care Plans – Initiated within 48 hours and reviewed/signed by RN
  • UDA’s - for potential MDS opportunities
• Participates in the onboarding process for orientation for new community interdisciplinary team members.
• Participates in all training as required including Relias, PCC, Point Right, SimpleLTC/TMHP, Optima and company program rollouts.
• Provides information to regional operations, clinical and community management team on the status of clinical and financial reimbursement.
• Interview and hire appropriate individuals to perform tasks under his/her supervision.
• Supervise team members’ performance of assigned tasks in accordance with established procedures and policies.
• Perform other duties as assigned by the community administrator.

• A current and valid Texas RN nursing license or a current and valid RN license from a Compact Party State.
• Current Basic Life Support (BLS) / Cardiopulmonary Resuscitation (CPR) certification required prior to performing work, preferably from the American Heart Association (AHA), or the ability to obtain certification within thirty (30) days of employment.
• Familiar with Reimbursement system of Medicare, Medicaid & Case Management.
• Knowledge of state and federal regulations, both clinical and financial as it relates to the RAI process and reimbursement systems.
• Knowle…