2.4 Ensures timely and accurate compliance of the MDS process and that it reflects the patient's plan of care; 2.5 Participates with the interdisciplinary team in developing, implementing and evaluating ways to achieve patient goals and minimize rehospitalizations; 2.6 Ensures Point Click Care (PCC) is utilized according to the Business Processes; 2.7 Contacts attending physician to obtain orders as indicated (i.e., admission, change in condition, etc.); 2.8 Ensures that Physician Orders are followed as prescribed; 2.9 Oversees medication management to ensure adequate supplies and that all medications are handled in accordance Genesis policy; 2.10 Ensures that patient's attending physician and family or responsible party are promptly notified of any significant change in the patient's health condition; 2.11 Creates an environment that is respectful, team oriented and responsive to the concerns of staff, patients and families; 2.12 Ensures communication between licensed nursing staff and CNAs during and between shifts; 2.13 Participates in shift-to-shift communication between incoming and outgoing nursing staff; 2.14 Serves as a role model in the delivery of direct patient care using the nursing process; 2.15 Provides patient care when required; 2.16 Ensures discharge planning process is in place and provides consultation as needed; 2.17 Ensures complete and prompt reporting of incidents, accidents, and adverse events to Administrator and Director of Nursing. Quality Improvement: 4.1 Participates in the development, implementation and evaluation of quality improvement activities for the Center and/or unit as requested; 4.2 Prepares written reports, reviews records and participates in needed data collection as indicated; 4.3 Reviews clinical records of patients with unplanned rehospitalizations to identify areas in need of improvement; 4.4 Ensures that patient's accident/incident, adverse event and grievances/concerns are fully documented, investigated, reported and addressed in accordance with Genesis policies and procedures and the Federal/State rules and regulations;