MDS Program Director RN

RESPONSIBLE TO:

Director of Health Care Services

General Manager

Corporate Consultant

PURPOSE:

? To oversee and coordinate the resident assessment process including, but not limited to, training of staff in the assessment process, coordinating schedules for completion of the MDS forms on admission, quarterly and annually on all residents.

? Coordinates assessment completion in accordance with OBRA and Medicare guidelines

? Participates in guest care conferences, reviews guests for significant changes on an on-going basis to insure proper care planning for guests.

? Keeps all staff advised on changes in MDS system

? Promotes an optimal level of wellness for each guest in the facility.

? Maintains compliance with all policies and procedures of the facility as well as State and Federal Regulations.

? Acts as facility PPS program monitor

QUALIFICATIONS:

? Licensed R.N. with previous management experience in a long term care facility.

? Knowledge of State and Federal Regulations.

? MDS certification preferred

? MDS experience preferred

DUTIES:

The duties of the position may include, but are not limited to the following areas:

MDS Assessment

? Schedules the MDS process for all residents as mandated by State and Federal Regulations.

? Oversees the timely completion of all MDS assessments and forms.

? Monitors residents for significant change and generates the appropriate assessment and completion of forms.

? Face Sheet completion with diagnosis prioritized. Ensures priority diagnosis is communicated to the team

? Has working knowledge of the RAI manual and updates released

? Understands and schedules OBRA required assessment in accordance with regulations

? Understands and scheduled Medicare (PPS) assessments in accordance with regulations

? Understands and scheduled unscheduled PPS and OBRA assessments when identified

as applicable to a guest’s condition.

? Performs discharge assessments as required

? Performs entry tracking records as required

? Ensures interdisciplinary completion of the CAA process

? Ensure CAA summaries contain risk/benefit analysis as necessary

? Ensures therapy log is attached to each completed PPS MDS verifying therapy minutes provided.

? Submits all required MDSs timely

? Captures required signatures for MDS completion and files the MDS in accordance with regulation and facility procedure.

? Accesses and shares CASPER reports with Director of Health Services and General Manager

? Understands and applies appropriate reasoning for selection of assessment reference date

? Initiates certifications and tracks the need for recertification

? Able to contact MDS help desk or QTSO for technical issues

Medicare Meetings

? Attends weekly Medicare meetings

? Discusses current ADL scores for each guest based on review of available documentation

? Discusses current RUG level

? Able to articulate reason for coverage and estimated end of coverage for guests based on knowledge of Medicare skill criteria

Notice of Noncoverage

? Evaluates the need for administering notice of noncoverage based on Medicare criteria

? Administers notice of noncoverage and explains guest appeal rights

? Ensures the correct notice is provided based on services/insurance used for coverage

? Administers notice of exclusion from Medicare benefits when applicable

? Understands and assists in the advance beneficiary notice process

Expedited Appeals

? Immediately notifies Director of Health Services, General Manager, and Corporate Consultant of receiving notice of expedited appeal

? Coordinates expedited appeal

? Drafts detailed notice of noncoverage and provides a copy to the guest and QIO.

? Understands Medicare audit process

Survey Participation

? Shares in the duties/responsibilities with the Director of Health Care Services as delegated.

? Creates QI/QM reports routinely and provides copies to Director of health Services and general manager

? Makes rounds as instructed by the director of health Services

? Keeps facility Roster current and provides a copy to Director of Health Services weekly

? Reviews facility census and conditions form for accuracy. Provides a copy weekly to Director of Health Services and General Manager

Communication

? Collaborates with all departments.

? Review PPS reports and communicates inaccuracies to billing department, facility

directors, and corporate consultant

? Communicates changes in RUG scores or corrections made to MDSs to billing.

? Responsible for communicating default rates immediately to GM/DHS.

Care Planning

? Reviews all resident care plans on a regular basis to insure a proper plan of care is in place.

? Updates care plans upon change in condition

? Ensure current plan of care reflect current condition of the guest

Care Conference

? Attends care conferences for families.

? Acts as nursing representative for care conference

Discharge Planning

? Reviews Medicare skill criteria continuously and communicates changes to social service and team for discharge planning as appropriate.

? Assists social service in discharge planning as necessary

Ancillary Assessments

? Oversees the completion of ancillary assessments (i.e. fall risk assessment, dehydration assessment, BIMS, PHQ 9, etc).

? Ensure ancillary assessments are completed quarterly and with any significant change

Education

? Participates in the facility in-service program to train personnel in the MDS process.

? Provides education for staff on changes in MDS process

? Identifies and address learning needs regarding the MDS process

Insurance

? Understands criteria, documentation, and MDS requirements for several different insurances

Cost Analysis

? Performs cost analysis as necessary

Therapy Meetings

? Participates in monthly therapy meeting

? Able to articulate RUG groups and how they were generated

? Understands RUG groupers and PPS rates associated

? Participates in facility analysis of unplanned discharges.

Miscellaneous

? Promotes and maintains a good rapport among all departments, residents, public, and visitors.

? Other related duties as assigned.

? Upholds Resident Bill of Rights at all times.

? Acts as supervisor for any additional MDS staff.

? Acts as supervisor of nursing staff

DUTIES TO STAFF:

? Keep team members informed of work requirements.

? Let team members know where they stand.

? Become familiar with company resources, services and personnel available to you.

? Help team members improve and broaden their skills.

? Compliment team members for a job well done.

? Provide the opportunity for group and individual participation for solving operational problems.

? Treat all members of the group as equals.

? Delegate responsibilities and encourage the acceptance of such responsibilities by all members of the work team when necessary.

? Understand each team member’s job and clarify the importance of each job in relation to the group.

? Appreciate and attempt to solve and eliminate team member’s problems, no matter how small.

? Be polite and cooperative at all times.

WORKING CONDITIONS:

Works in office areas as well as throughout the facility and its premises

Moves throughout building intermittently during working hours

Is subject to frequent interruptions

Is involved with guests, family members, personnel, visitors, government agencies/personnel, etc. under all conditions/circumstances

Is subject to hostile and emotionally upset guests, family members, personnel and visitors

Is subject to injury from falls, burns from equipment, odors, etc., throughout the day as well as reactions from dust, disinfectants, and other air contaminants

Is subject to exposure from infectious waste, disease, conditions, etc., including TB and the AIDS and Hepatitis B viruses

May be subject to the handling of and exposure to hazardous chemicals

Communicates with the medical staff, nursing personnel and other departments or supervisors

Maintains a liaison with the guests, their families, support personnel, etc., to assure that the guest’s needs are continually met.

PHYSICAL AND SENSORY REQUIREMENTS (with or without the aid of mechanical devices)

- Must be able to move frequently throughout the work day

- Must be able to speak and write the English language in an understandable manner

- Must be able to cope with physical and emotional stress of the position

- Must possess sight/hearing senses or use prosthetics that will enable these senses to function adequately so that the requirement of this position can be fully met

- Must meet the general health requirements set forth by the policies of this facility which include a medical and physical examination

- Must have the ability to work effectively with residents and personnel.

- Must be able to push, pull, move, and/or lift a minimum of 25 lbs. to a minimum height of 3ft. and be able to push, pull, move, and/or carry such weight a minimum distance of 10 feet.

Specific Physical Responsibilities include:

Ability to perform at one time:

Sitting: Up to 2 hours in an 8 hour shift

Standing: Up to 7 hours in an 8 hour shift

Walking: Up to 7 hours in an 8 hour shift

Driving: Occasionally

Ability to perform in an 8 hour shift:

Sitting: Up to 4 hours in an 8 hour shift

Standing: Up to 7 hours in an 8 hour shift

Walking: Up to 7 hours in an 8 hour shift

Ability to Lift:

Up to 10 lbs: Continuously

11 – 20 lbs: Frequently

21 – 25 lbs: Frequently

26 – 50 lbs: Occasionally

51 – 85 lbs: Occasionally

85+: Occasionally

Ability to Carry:

Up to 10 lbs: Continuously

11 – 20 lbs: Frequently

21 – 25 lbs: Frequently

26 – 50 lbs: Occasionally

51 – 85 lbs: Occasionally for very short distance

85+: Not at this time

Use of hands, must be able to perform:

- Simple Grasping

- Fine Work

- Pushing/Pulling

- Low Speed Assembly

- High Speed Assembly

Use of Feet, must be able to perform:

- Repetitive movement as in pushing/pulling with right leg

- Repetitive movement as in pushing/pulling with left leg

- Repetitive movement as in pushing/pulling with both legs at same time

Must be able to perform the following:

Bending: Frequently

Squatting: Frequently

Crawling: Occasionally

Climbing: Occasionally

Reaching: Continuously

Kneeling: Occasionally

Twisting: Frequently