MDS / Care Plan Coordinator Nurse

Helia Healthcare Saint Louis, MO

JOB SUMMARY

The overall purpose of the MDS/CARE PLAN COORDINATOR position is to manage the integrity of the facility's RAI and Medicare processes. This includes assuring that residents receiving Medicare services qualify for those services, that all documentation required to support continuing stay is completed, that MDS/PPS assessments are completed timely and accurately according to regulations and that skilled nursing care is provided on a continuing basis.

ESSENTIAL DUTIES AND RESPONSIBILITIES

* Obtains and maintains timely physician certifications for each Medicare resident.

* Coordinates preparation of MDS and Care Plan as per regulatory requirements.

* Updates care plans as needed or indicated.

* Maintains MDS/Care plan schedule for interdisciplinary team.

* Invites families and/or residents to participate in care plan meetings in writing at least two weeks prior to meeting date. The MDS coordinator is flexible with scheduling to meet the needs of the resident and family.

* Remind and assist residents to care plan meetings.

* Assures daily documentation of assessment for each Medicare resident on a daily basis.

* Verifies daily Medicare documentation is appropriate and meets Medicare coverage guidelines.

* Tracks Medicare resident benefit days, validates daily Medicare census and coordinates this information with the Business Office Manager to assure accurate billing.

* Coordinates weekly Medicare meeting with Interdisciplinary Team.

* In cooperation with the Social Service Director, keeps responsible parties/residents abreast of continuing or ending Medicare coverage.

* Completes responses to requests for additional information from the intermediary and appeals decisions, when necessary, within established time frames.

* Assures preparation of Medicare denial letters for each resident discharged form Medicare coverage within time limits imposed by Medicare guidelines.

* Participates in the ongoing evaluation of documentation required for Medicaid reimbursement.

* Monitors the appropriate MDS web site for up to date changes.

* Submits MDS assessments to E-Health for analysis and corrects as needed.

* Transmits assessments per regulatory guidelines to the state repository, receives validation reports, corrects errors and resubmits as needed.

* Monitors compliance with Dart Chart documentation for nursing personnel.

* Maintains RUG variance rate of less than 2% as compared to DART Chart System Calculations.

* Other duties as assigned by management.

EDUCATION AND EXPERIENCE REQUIREMENTS

* A current, valid RN Illinois Nurse license is required.

* Education/and or experience in long-term care, acute care, or geriatric nursing preferred. MDS/RAI experience highly preferred.

* Functional literacy in English is required.

* No disqualifying criminal offenses as defined by regulatory guidelines.

* Proficiency in computer use/data entry.

PHYSICAL DEMANDS

* Ability to communicate in English via phone, in writing, and verbally in conversations with different levels of staff, patient families, and any outside customers.

* The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

* While performing the duties of this job, the employee is frequently required to stand and walk. The employee is occasionally required to sit; use hands or fingers, handle, or feel; reach with hands and arms; talk or hear; and taste or smell.

* The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus. Ability to utilize a computer, phone, etc. for extended periods of time.

* While performing the duties of this job, the employee is occasionally exposed to blood or other body fluids, fumes or airborne particles and toxic or caustic chemicals. The noise level in the work environment is usually moderate.