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JOB SUMMARY: The MDS-RN will assist the Director of Nursing with ensuring that documentation in the center meets federal, state and certification guidelines. The MDS-RN will coordinate the RAI process ensuring the 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 
● Coordinates 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 

QUALIFICATIONS: 

Required 
● Current RN 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