Location: Louisville,KY, USA
Located in beautiful Louisville, Kentucky, Landmark of Louisville takes pride in serving the local community and surrounding communities, and always strives to put the resident first. We offer comprehensive skilled medical care, rehab-to-home programs, long term care services, hospice services and a variety of other healthcare services. We offer spacious rooms, two in-house therapy gyms, dining rooms on every floor, and daily activity programs. Private rooms are also available. Our facility is an integral part of the community, and we treat our residents like family.
Benefits:
Paid Time Off (Vacation, Sick, Holiday and Birthday Pay)
PTO Cash Out Option
Payactiv (Get paid next day)
Insurance (Medical, Dental, Vision and More)
401K
Wonderful Team to Work With!
Flexible Schedule
Tuition Reimbursement
POSITION SUMMARY:
The Resident Assessment/Care Plan Coordinator is responsible for the coordination of the Resident Assessment Instrument process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payer program requirements.
A MDS (Minimum Data Set) Coordinator/Nurse is either a Licensed Practical (LPN) or Registered Nurse (RN) that conducts federally mandated assessments of the residents at a long-term care facility. MDS Coordinators are responsible for collecting integral data and compiling it into a thorough assessment to help determine the functional capacity with appropriate plan of care and to determine the reimbursement for all payer sources in relation to the RUG-IV 66 and RUG-IV 48 system established by the Centers of Medicare and Medicaid Services.
The MDS Coordinators gather information on the facilitys current residents for MDS assessment completion requirements determined by the RAI (Resident Assessment Instrument) and include, but not limited to the residents physical and mental status. They assess the medical record, EMR system documentation and communicate with other healthcare teams to create applicable health care plans for their current and incoming residents. MDS Coordinators aim at promoting the emotional and physical well-being of the residents of the nursing facility. A Resident Assessment Instrument(s) (RAI) are used for collection of information from families of residents, and the residents themselves by conducting interviews, initially and as well as periodically. The residents nutritional requirements, cognitive ability, physical status, behavior patterns and mood and other areas are taken into account by the MDS Coordinator. Certified Nursing Assistants, Restorative Aides, Unit Nurses and other facility staff use the information derived from these MDS assessments in the formulation of care plans tailored to satisfy the requirements of individual resident needs. Such care plans are implemented and monitored by MDS Coordinators in ensuring their effectiveness. The MDS Coordinators strive to ensure that the strategies are consistent with ethical standards and Medicare/Medicaid requirements. The MDS Coordinator(s) also observe and document the pricing and effectiveness of these services.
The MDS Coordinators must also conduct new resident assessments, such as Care Area Assessments (CAAs) to help stabilize and/or improve the practices of their health care facility. They also provide OBRA (Omnibus Reconciliation Act of 1987) assessments to ensure that the facility complies with Medicaid and Medicare standards. An MDS Coordinator is also responsible to function as the main communicator post resident admission/re-admission between the Insurance/Managed Care Providers to provide a review of the plan of care and to obtain re-authorizations for ongoing TX/Services.
ESSENTIAL JOB FUNCTIONS:
Prior to or at the time of admission, review resident records for skilled services meeting the guidelines for Medicare coverage, as appropriate
Provide Medicare Charting Guidelines to nursing staff, as appropriate
Manage Medicare A Certification / Re-Certification process per CMS guidelines and timeframes
Coordinate the Resident Assessment Instrument (RAI) process including completion of an accurate Minimum Data Set (MDS) and development of the interdisciplinary Plan of Care (CP)
Review records for diagnoses and complete ICD-9 Coding (ICD-10 as of 10/1/15) and sequencing for payer type, as needed
Prior to look-back period, meet with IDT to review resident programming and documentation requirements to maximize reimbursement and provide an accurate picture of the care being provided to the resident
Schedule resident for appropriate OBRA and/or Medicare PPS MDS (scheduled and unscheduled), per RAI and CMS guidelines and timeframes allowed
Work in collaboration with the Therapy Program Manager to ensure the most appropriate assessment date is utilized
Maintain Therapy Intensity Schedule COT binder and review daily with Therapy Program Manager scheduling COT OMRAs as necessary
Perform ongoing evaluation from pre-admission through discharge to ensure an appropriate reimbursement level for each resident.
Reviews medical records, care plans, charting to ensure documentation supports care provided and reimbursement level.
Complete appropriate MDS interviews following designated script on or prior to the ARD within the window, document time/date and staff member completing the (include type) interview in the medical record on the day it occurred when indicated
At minimum, complete the sections assigned to the MDS Coordinator per facility processes (A, B, I, J, K0510A&B, K0700, L, M, N, O0100-O0450, 0600-0700, V, X, Z)
Strive to complete MDS sections within 2 working days after ARD
MDS Nurse to complete CAAs for Delirium, Visual, ADL (IN only), Urinary Incontinence and Urinary Catheter (IN only), Falls, Feeding Tubes, Dehydration, Dental, Pressure Ulcer, Psychotropic Drug, Restraints (IN only) and Pain
Oversight of all disciplines involved in the MDS process to strive to complete MDS, CAAs and CP within 2 working days after the ARD, the exception is preparing for Medicare billing which may reduce completion time to day after ARD.
Complete other sections of the MDS when incomplete to prevent late closure
Conduct weekly CMI Meetings (IN) and RUG-IV 48 Meetings (IL)
Utilize all available tools to validate the accurateness of the MDS
Signs MDS sections for accurateness RN must sign for completeness
Maintain supportive documentation packet for each OBRA and Medicare PPS MDS for validation of RUG
Audit MDS for validation of RUG audit should not be completed by the nurse completing the MDS
Create submission files and transmit MDS data timely to the State / CMS repository no later than 14 days after completion of MDS/PPS assessments and no later than 7 days after completion of Entry/Death in Facility Tracking
Review Validation Report for warnings and rejections, responding as appropriate, and maintain transmission Validation Reports
Review Assessment Due Report and PPS Assessments Due Report 2-3 times a week to track assessments that are due
Complete and provide MDS, PPS and CP Calendars to all disciplines involved in MDS and CP
Review telephone orders and update care plan problems, goals and approaches as necessary
Participate in Morning Meeting review to monitor for changes in resident condition
Perform modifications of assessments in accordance with CMS Policy
Participate in Claims Triple Check Procedure
Ensure Care Plan Conference Process is followed by all disciplines
Ensure Care Plan Update Process is followed by all disciplines
Ensure End of Month Billing Process is completed timely
Maintain Benefits Exhaust Log and fax to designated biller each month
Participates in assigned meetings as deemed necessary
Ensure Medicare Meeting Process is followed by all disciplines
Attends in-service training and other educational programs as directed or authorized.
Performs all job duties in a manner that ensures that confidential information and residents rights are protected at all times
Responsible for facilitating, preparing, implementing appropriate procedures to meet the needs ethically of the reimbursement entities surveying the facility
Complies with established standards described in facility policies and procedures, code of conduct, corporate compliance plan, employee handbook and other company documents and publications.
Performs other duties or functions as directed.
Monitor Point Click Care (Point of Care) documentation daily and report non-compliance to the DON and/or designee. Complete POC documentation during the ARD period and PRN.
Coordinate of data collection for the ADR Process (Additional Documentation Requests) for Medicare Part A and B as well as Managed Care.
EDUCATION/EXPERIENCE:
Must possess, as a minimum, a Nursing Degree from an accredited college or university.
Optional: Certification programs for MDS Coordinators are available through the American Association of Nurse Assessment Coordinators (AANAC). The AANAC offers credentials such as Resident Assessment Coordinator and Certified and Certified Nurse Executive.
Our company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, our company complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. #123