Coordinate the RAI process, which includes, at a minimum, the following elements:
• Minimum Data Set (MDS)
• Care Area Assessment process
• Care plan development
• Care plan implementation
• Evaluation
Provide oversight of assessment completion and transmission to the national repository. Review final validation reports and correct or modify assessments in response to warnings or errors as needed
Coordinate the completion of the comprehensive care plan according to regulatory requirements
Maintain the OBRA and PPS assessment schedules.
Be highly involved in determining skilled level of care for Medicare residents and procuring required Medicare-specific documentation; be responsible for physician certification/recertification of a skilled level of care throughout the Medicare stay; be involved in making Medicare eligibility determinations.
The MDS nurse will spend much of his or her day asking questions and interviewing anyone connected with residents in order to get assessments for the purpose of PDPM reimbursement. The MDS nurse will also look at residents’ BIMS scores and depression scale assessments in determining their care plans. Lead care plan meetings with families.
Responsible for assuring the timely completion of accurate resident assessments and interdisciplinary care plans that meet Federal and State guidelines. This includes identifying resident acuity and needs, helping to determine specific care needs, and communicating needs and expectations to families and responsible parties.
Assess charts and communicate with health care teams to create applicable health care plans for their current and incoming residents.
Coordinate care with case managers for residents utilizing managed care, health maintenance organizations (HMOs), commercial insurance, and other alternate payment models.
Maintain compliance with state-specific regulations regarding the RAI process.
Provide insight and analysis of MDS-based Quality Measures.
Serve as a member of the quality assessment and assurance (QAA) and/or the quality assurance and performance improvement (QAPI) committees.
Evaluate PDPM financial performance and regularly meet with Healthcare Administrator to review. Review EMAR / PCC or other systems for missed financial opportunities or errors. Ensure MDS system accepts assessments; prevent and resolve errors.
Work closely with hospital discharge planners and physicians to obtain accurate and complete documentation to support ICD-10-CM diagnosis coding and surgical procedures.
Audit and improve staff education/competency as needed to ensure accurate and timely completion of supporting documentation and MDS assessments.
Participate in discharge planning, training, caregiver training, and the provision of resources as needed..
Review resident complaints and grievances associated with the RAI process and care delivery protocols; make written reports of action taken; discuss with the resident, representative, and family as appropriate.
EDUCATION AND WORK EXPERIENCE:
Required Degree: Bachelor’s degree, Nursing
Certificate(s):
Registered Nurse in the state. RN license must be active and in good standing. Active licensure status maintained.
MDS Certified required. If not currently certified, may have 1 year to complete the certification in good faith.
Experience:
1+ year of nursing experience preferred.
MDS experience and regulatory experience is preferred, including experience with resident assessments (RAI process) and comprehensive resident centered care plans
Minimum of 1-2 years’ experience with geriatric clients.
PDPM experience / financial reimbursement experience preferred.
KNOWLEDGE, SKILLS AND ABILITY:
Use good judgement and make sound, independent decisions.
Clinical knowledge and technical expertise in nursing.
Solid understanding of data collection and analysis, including ability to understand financial reimbursement processes.
Clinical and computer systems awareness and knowledge.
Problem solving and critical thinking skills, including assessing problems and planning / evaluating solutions.
Effective time management, with ability to organize and prioritize work.
Patience, understanding and interpersonal skills.
Attention to detail and accuracy.
Ability to maintain confidentiality and handle sensitive information.
Good judgment and discretion.
Ability to work under pressure and to meet objectives and deadlines.
Professionalism and ability to work through difficult situations.
Excellent communication skills (written and verbal, English).
Understand customer service and team building concepts.
Ability to monitor and direct the activities of others.
Ability to enlist cooperation of unit personnel and staff in other departments. Ability to build consensus.
Ability to maintain good professional relationships with others and to relate well to residents and families.
#RN
Compensation Pay Range:
Reasonable Pay Estimate
A reasonable estimate of the pay range for this position is $80,591.00 - $113,388.50 per year. There are numerous factors taken into consideration in determining the actual offered rate of pay, including but not limited to: job-related qualifications, experience, skills, education, geographic location, and consideration of internal and external equity.For full time employees, we offer a generous benefits package that includes:
Medical, dental and vision insurance
Employer paid group term life and disability
Paid Time Off (PTO) & six paid holidays
403(b) with a 3% employer match
Fitness center use at most facilities.
Various voluntary benefits:
Life, AD&D
Tuition assistance and scholarships
Employee assistance program
Legal services, home/auto insurance, discount purchasing program
Pet Insurance
For more information about Covenant Living and CovenantCare at Home, please visit www.covliving.org or www.covenantcareathome.org.
Covenant Living and CovenantCare Home Health and Hospice are equal opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin or ancestry, age, disability, marital status, pregnancy, protected veteran status, protected genetic information, or any other characteristics protected by local laws, regulations, or ordinances.