JOB SUMMARY: The MDS-LVN will assist the Director of Nursing with ensuring that documentation in the center meets federal, state and certification guidelines. The MDS-LVN will coordinate the RAI process ensuring timeliness and completeness of the MDS, CAAS, and
Interdisciplinary Care Plan.
ESSENTIAL FUNCTIONS:
Assist the facility in assuring adherence to federal and state regulations and certification
Actively participate in the regulatory or certification survey process and the correction of deficiencies
Report trends from completed audits to the Quality Assurance Committee
Ensure completion of the RAI Process from the MDS through the completion of the plan of care
Initiate and monitor RAI process tracking, discharge/re-entry, and Medicaid tracking forms through the PCC & SimpleLTC systems
Follow up with staff when necessary to ensure compliance to standards of documentation
Collect data for each resident and interviews staff and residents as necessary to assure good standard of practice and as instructed in the most current MDS user manual
Facilitate accurate determination of the Assessment Reference Date that accurately reflects the patient's care needs and captures all resources utilized to ensure appropriate payment by Medicare/Medicaid and insurance programs
Provide interdisciplinary schedule for all MDS assessments and care plans as required by OBRA and PPS
Ensure appropriate signatures are obtained as required
Ensure that the interdisciplinary team makes decisions for either completing or not completing additional MDS assessments based on clinical criteria as identified in the RAI manual
Respond to change in conditions appropriately
Coordinate scheduling notice of patient care planning conference and ensure communication of outcomes/problems to the responsible staff, patient and/or responsible party
Ensure all MDS information and care delivered as outlined in the Care Plan is supported by documentation
Assist the Administrator/Director of Nursing with monitoring to ensure that a care plan is initiated on every patient upon admission to the center
Participate in the daily Interdisciplinary Team meeting and communicate needs for changes in PPS Timeliness and Assessment Reference Dates and deficiencies in completion of MDS, CAA and Care Plan
Relay and/or act upon information from the Clinical Reimbursement Specialist audits
Act as a resource person for computer issues that relate to the MDS process; contact the help desk when indicated
Maintain proficiency in software programs
Responsible for ensuring appropriate Medicare coverage through regular communication with Clinical Reimbursement Specialist Sequence appropriate diagnosis coding for residents
Correct and ensure completion of final MDS and submit resident assessment data to the appropriate state and Federal government agencies in a timely manner
Assign, assist and instruct all staff in the RAI Process, PPS Medicare, Medicaid (Case Mix as required) and clinical computer system in relation to these processes
Ensure timely submission of the MDS to the state with proper follow up on validation errors; maintains validation records from the submission process in a systematic and orderly fashion
Maintain confidentiality of necessary information
Remain proactive with staying current on all industry changes
Assist with OIG reviews, ADR's, RAC audits, etc. as needed with professionalism
Coordinate monthly Triple Check meeting for Medical billing compliance
Complete LTCMI timely on TMHP portal and communicate with BOM regarding payer changes to ensure no loss in Medicaid payment
Understand and adhere to the guidelines of “Residents Rights” and assure resident safety
Requirements
QUALIFICATIONS:
Required
Current LVN license
CPR certified required; 30 days will be given to complete a course and get certified
Excellent knowledge of RAI Process, the federal Medicare PPS process, and Medicaid reimbursement as required
Thorough understanding of the Quality Indicator process
Knowledge of the OBRA regulations and Minimum Data Set Knowledge of the care plan process
Preferred
2 years nursing experience in long term care/skilled nursing
PHYSICAL REQUIREMENTS: The ability to safely perform movements such as pushing, pulling, lifting, bending, kneeling, and reaching up to 50 pounds with or without reasonable accommodations
WORK SCHEDULE: As assigned, including some weekends, evenings and holidays
WORK ENVIRONMENT: Clinical
Caraday Healthcare provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetics, or any other characteristic protected by law.
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