Summary:
Conduct, coordinate, the continuity of care for skilled resident in accordance with the requirements of the Federal and State regulations as well as Company policy and procedure. Monitor/analyze the clinical reimbursement in a building, working with the team to move the building forward; providing customer service, updates, continues authorizations, discharge planning, and all other duties for smooth transitioning for residents from ST/LT or ST to home.
Environment:
Work will be performed primarily indoors at one or all of our long-term healthcare facilities, throughout all areas, including in resident rooms, and on carpeted and/or tiled floors. Work will be performed there routinely around other co-workers, healthcare staff, residents, and guests. Due to the nature of facility’s business, worker may be exposed to occasional slippery floors, object on floors, chemicals, sharp objects, hazardous materials and waste (including human), blood borne pathogens, and communicable diseases, as well as high-stress medical and/or life threatening situations.
Essential Duties & Responsibilities:
- Meet physical and sensory requirements stated below, and be able to work in the described environment.
- Identify and participate in process improvement initiatives that improve the customer experience, enhance work flow, and/or improve the work environment.
- Lead/participate/teach in Daily PDPD meetings, weekly discharge meetings, 72 hour meetings, and month end meetings to assure federal billing requirements are met.
- Assist in completion of the Resident Assessment Instrument with the Interdisciplinary Team when needed.
- Notify all Interdisciplinary Team members of the MDS Assessment schedule for skilled payer sources.
- Notify all Interdisciplinary Team members of changes to the MDS Assessment schedule for skilled ll payer sources.
- Information to complete the MDS is to be collected using the medical record, bedside assessment, and staff, resident and/or family interviews.
- Teach and monitor a system to verify that all Interdisciplinary Team members have completed, dated, and signed the assessments according the Federal Regulations.
- Teach If a member of the Interdisciplinary Team is absent the MDS Coordinator is to verify that the all sections of the MDS are complete, accurate, and attest to the accuracy of the sections.
- Review prior to closing and transmitting the MDS to assure all sections have been completed, dated, and signed according to Federal Regulation.
- Teach to Verify all MDS documents required either by Federal and/or State Guidelines or Organizational policy are easily available at all times.
- Validate the ARD and Reason for Assessment with Therapy Services prior to transmission.
- Assure MDS assessments are transmitted timely as set forth by the Federal Regulations.
- Review the Final Validation Note fatal records that were rejected and take appropriate action assuring a rejected MDS is accepted in the Federal Repository prior to end of month billing.
- Upon completion of the MDS the Care Area Assessments (CAA’s) must be completed timely according to Federal Regulations.
- The CAA’s must contain sufficient information that supports whether or not the Care Area triggered will be Care Planned.
- The CAA will clearly state whether the problem “will proceed to care plan” or “will not proceed to care plan.”
- When it is determined that a triggered Care Area will not be care planned the reasoning for not proceeding must clearly indicate clinical rational.
- Consult the CAA Summary Sheet and verify that all triggered CAA’s and corresponding narrative summaries have been completed, dated, and signed by the appropriate disciplines.
- Using information from the MDS Assessment and CAA’s develop an Interdisciplinary Plan of Care.
- Review Plan of Care at least quarterly and with each Comprehensive Assessment to assure changes during the quarter are included and updated.
- Teach Care Plans must contain problem, goals, and interventions.
- Teach/Lead or Participate in Interdisciplinary Care Plan meetings for skilled residents.
- Provide ongoing communication with families, managed care reps, IDT.
Job Requirements:
- Licensed Nurse with required current state licensure.
- MDS experience preferred.
- Minimum three (3) years of clinical experience in a health care setting; long-term care setting preferred.
- Personal integrity and professionalism to work effectively with the Interdisciplinary Team, Patients, and Families.
- Knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care.
- PCC knowledge.
- Excellent analytical and deductive reasoning skills.
- Effective verbal and written English communication skills.
- Demonstrated basic to intermediate skills in Microsoft Word, Excel, Power Point and Outlook, Internet and Intranet navigation.
- Highest level of professionalism with the ability to maintain confidentiality.
- Ability to communicate at all levels of organization and work well within a team environment in support of company objectives.
- Customer service oriented with the ability to work well under pressure.
- Strong attention to detail and accuracy, excellent organizational skills with ability to prioritize, coordinate and simultaneously maintain multiple projects with high level of quality and productivity.
- Strong analytical and problem solving skills.
- Ability to work with minimal supervision, take initiative and make independent decisions.
- Ability to deal with new tasks without the benefit of written procedures.
- Approachable, flexible and adaptable to change.
- Function independently, and have flexibility, personal integrity, and the ability to work effectively with employees and vendors.
- Ability to travel.
Physical and Sensory Requirements:
- Moderate physical activity:
- Push, pull, move, and/or lift a minimum of twenty-five (25) pounds to a minimum height of three (3) feet and be able to push, pull, move, and/or carry such weight a minimum distance of fifty (50) feet.
- Standing and/or walking for more than four (4) hours per day.
- Bending and/or stooping for more than one (1) hour at a time.
- Sitting for more than two (2) hours at a time.
- Requires writing and/or computer work with repetitive typing and concentrating on computer screen and/or documents for more than two (2) hours at a time.
