MDS Director

MDS Director

Lake Country Health Services is a leading provider of skilled nursing and rehabilitation services. As part of North Shore Healthcare, the largest post‑acute provider in the Upper Midwest, we operate 70 skilled nursing and assisted‑living centers across Wisconsin, Minnesota, Michigan and North Dakota. We are seeking an exceptional individual to lead the Resident Assessment Instrument (RAI) process, ensuring accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payer program requirements.

• Oversees and coordinates the development and completion of the resident assessment (MDS) in accordance with current Federal and state regulations
• Coordinates and leads the development of a comprehensive resident assessment and care plan for each resident as chairperson of the center Interdisciplinary Plan of Care team
• Ensures the face validity of all Minimum Data Sets before electronic submission
• Combines the timely electronic submission of all MDS
• Conducts a monthly review of a random sample of the MDS to ensure accuracy and internal consistency with the medical record
• Coordinates the completion of each resident’s MDS in compliance with all State and Federal requirements
• Calculates triggers and develops resident assessment protocols for initiation of care plan
• Ensures MDSs are completed timely and accurately identifies each resident’s level of functioning per RAI manual guidelines
• Ensures each MDS identifies the lowest level of functioning allowable to maximize reimbursement opportunities as allowed by Federal and State Law
• Ensures CNAs, nurses and other disciplines complete required clinical record documentation timely
• Coordinated and assisted with weekly interdisciplinary care conferences and Medicare meetings
• Makes necessary referrals to nursing and therapy departments
• Maintains MDS and supporting clinical record documentation per State and Federal requirements and center policies/procedures
• Reviews and assesses all resident information (including hospital records) to accurately complete MDS scoring
• Trains nursing staff on responsibilities for timely and accurate clinical record documentation
• Ensures Medicare claims relating to MDS pending and therapy pending errors are corrected
• Generates MDS audit reports as needed
• Verifies Medicaid billing accuracy and maintains accurate billing for HMO and VA residents
• Compiles monthly and quarterly Medicare/Medicaid default reports
• Ensures MDS submission and report preparation, processing (CASPER, Validation Reports, etc.) and distribution
• Identifies MDS/Census and AR errors for corrections for center billing information
• Provides training on clinical software and Care Tracker
• Participates in the interdisciplinary care team
• Stays current with state and federal regulatory changes
• Complies with laws and regulations applicable to the position and acts in accordance with the Center’s Compliance Program
• Attends and participates in in‑service training, performance improvement (“PI”) committees and other meetings as scheduled and directed
• Knows and follows center rules, dress and hygiene policies, smoking policies, uses required protective equipment, and follows infection control standards, policies and procedures
• Reports equipment needs or repairs, hazardous conditions/equipment, incidents, accidents or other safety matters to appropriate center personnel
• Performs duties that may include transportation of residents, as assigned in Center Disaster Plan
• Supports resident rights, helps residents exercise and/or protect their rights, and reports complaints to management
• Maintains confidentiality of resident/patient information per HIPAA policies
• Follows and adheres to Center’s HIPAA policies and procedures for privacy and security of protected health information
• Uses and discloses only the minimum amount of Protected Health Information necessary to complete assigned tasks
• Reports all suspected violations of company’s HIPAA policies or procedures to Center Privacy Designee

• Registered Nurse (RN) in good standing with the respective state licensing board
• Clinical experience, education or…