North Shore Health
MDS Director - Full-Time
at
North Shore Health
Summary/Objective: Responsible for the direction and administration of the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payor program requirements. Ensures assessments reflect the physical, mental and psychosocial status of each resident; ensures accuracy of RAI to reflect optimal reimbursement for services; ensures appropriate documentation to support services provided and assessment accuracy.
Responsibilities
Oversees and coordinates the development and completion of the resident assessment (MDS) in accordance with current Federal and state regulations
Lead the development of a comprehensive resident assessment and care plan for each resident as chairperson of the center Interdisciplinary Plan of Care team
Ensure the face validity of all Minimum Data Sets before electronic submission
Coordinate timely electronic submission of all MDS
Conduct monthly reviews of random MDS samples to ensure accuracy and alignment with the medical record
Coordinate completion of each resident’s MDS in compliance with State and Federal requirements
Calculate triggers and develop resident assessment protocols for initiation of care plan
Ensure MDS is completed timely and accurately identify each resident’s level of functioning
Ensure MDS accurately identifies the lowest level of functioning to maximize reimbursement where allowed by law
Ensure CNAs, nurses and other disciplines complete required clinical record documentation timely
Coordinate and assist with weekly interdisciplinary care conferences and Medicare meetings
Make necessary referrals to nursing and therapy departments
Maintain MDS and supporting clinical record documentation per state/federal requirements and center policies
Review and assess all resident information to accurately complete MDS scoring
Train nursing staff on timely and accurate clinical record documentation
Development
Ensure Medicare claims related to MDS and therapy pending errors are corrected
Generate MDS audit reports as needed
Implementation
Verify Medicaid billing accuracy
Maintain accurate billing for HMO and VA residents
Compile monthly/quarterly Medicare/Medicaid default reports
Ensure MDS submission, reporting, processing (CASPER, Validation Reports) and distribution
Identify MDS/Census and AR errors for corrections in center billing information
Provide training on clinical software and Care Tracker
Participate in interdisciplinary care team
Stay current with state and federal regulatory changes
Comply with laws and regulations applicable to the position and center Compliance Program
Attend and participate in in-service training, PI committees and other meetings as scheduled
Safety
Know and follow center rules
Follow center dress and hygiene policies
Demonstrate proper use of equipment; report needs or repairs
Follow center smoking policies
Report incidents/accidents of residents, staff or visitors
Report hazardous conditions/equipment to Supervisor
Perform duties including transportation of residents as assigned in Center Disaster Plan
Use required protective equipment
Follow infection control standards, policies and procedures
Resident Rights
Know Resident Rights and help residents exercise or protect their rights
Report resident/patient complaints to management
Maintain confidentiality of resident/patient information
HIPAA
Follow HIPAA policies for privacy and security of protected health information
Use/disclose only minimum necessary PHI for tasks
Report suspected violations of HIPAA policies to Center Privacy Designee
Qualifications
Required Education and Experience:
Registered Nurse (RN) in good standing with state licensing board
Clinical experience or education in geriatrics
Competence in PPS assessment and OBRA compliance
Excellent clinical assessment, organization and independent decision-making skills
Knowledge of state and federal regulations governing center practices
Excellent interpersonal skills
Computer proficiency with Microsoft products
Preferred Education and Experience:
2+ years of prior MDS/healthcare experience
Experience in a fast-paced environment
Post-acute care or healthcare experience preferred
Skills, Knowledge and Abilities Experience using MDS software and Microsoft Office; strong communication, organizational and project management skills; ability to work with all levels of staff; proficient in English; knowledge of MDS/RAI with Medicare/Medicaid payor systems; ability to learn company applications.
Our mission is to establish a culture that reinforces the values necessary to be the premier health services provider and employer in the communities we serve. North Shore Healthcare is the Right Choice for you.
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at
North Shore Health
Summary/Objective: Responsible for the direction and administration of the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payor program requirements. Ensures assessments reflect the physical, mental and psychosocial status of each resident; ensures accuracy of RAI to reflect optimal reimbursement for services; ensures appropriate documentation to support services provided and assessment accuracy.
Responsibilities
Oversees and coordinates the development and completion of the resident assessment (MDS) in accordance with current Federal and state regulations
Lead the development of a comprehensive resident assessment and care plan for each resident as chairperson of the center Interdisciplinary Plan of Care team
Ensure the face validity of all Minimum Data Sets before electronic submission
Coordinate timely electronic submission of all MDS
Conduct monthly reviews of random MDS samples to ensure accuracy and alignment with the medical record
Coordinate completion of each resident’s MDS in compliance with State and Federal requirements
Calculate triggers and develop resident assessment protocols for initiation of care plan
Ensure MDS is completed timely and accurately identify each resident’s level of functioning
Ensure MDS accurately identifies the lowest level of functioning to maximize reimbursement where allowed by law
Ensure CNAs, nurses and other disciplines complete required clinical record documentation timely
Coordinate and assist with weekly interdisciplinary care conferences and Medicare meetings
Make necessary referrals to nursing and therapy departments
Maintain MDS and supporting clinical record documentation per state/federal requirements and center policies
Review and assess all resident information to accurately complete MDS scoring
Train nursing staff on timely and accurate clinical record documentation
Development
Ensure Medicare claims related to MDS and therapy pending errors are corrected
Generate MDS audit reports as needed
Implementation
Verify Medicaid billing accuracy
Maintain accurate billing for HMO and VA residents
Compile monthly/quarterly Medicare/Medicaid default reports
Ensure MDS submission, reporting, processing (CASPER, Validation Reports) and distribution
Identify MDS/Census and AR errors for corrections in center billing information
Provide training on clinical software and Care Tracker
Participate in interdisciplinary care team
Stay current with state and federal regulatory changes
Comply with laws and regulations applicable to the position and center Compliance Program
Attend and participate in in-service training, PI committees and other meetings as scheduled
Safety
Know and follow center rules
Follow center dress and hygiene policies
Demonstrate proper use of equipment; report needs or repairs
Follow center smoking policies
Report incidents/accidents of residents, staff or visitors
Report hazardous conditions/equipment to Supervisor
Perform duties including transportation of residents as assigned in Center Disaster Plan
Use required protective equipment
Follow infection control standards, policies and procedures
Resident Rights
Know Resident Rights and help residents exercise or protect their rights
Report resident/patient complaints to management
Maintain confidentiality of resident/patient information
HIPAA
Follow HIPAA policies for privacy and security of protected health information
Use/disclose only minimum necessary PHI for tasks
Report suspected violations of HIPAA policies to Center Privacy Designee
Qualifications
Required Education and Experience:
Registered Nurse (RN) in good standing with state licensing board
Clinical experience or education in geriatrics
Competence in PPS assessment and OBRA compliance
Excellent clinical assessment, organization and independent decision-making skills
Knowledge of state and federal regulations governing center practices
Excellent interpersonal skills
Computer proficiency with Microsoft products
Preferred Education and Experience:
2+ years of prior MDS/healthcare experience
Experience in a fast-paced environment
Post-acute care or healthcare experience preferred
Skills, Knowledge and Abilities Experience using MDS software and Microsoft Office; strong communication, organizational and project management skills; ability to work with all levels of staff; proficient in English; knowledge of MDS/RAI with Medicare/Medicaid payor systems; ability to learn company applications.
Our mission is to establish a culture that reinforces the values necessary to be the premier health services provider and employer in the communities we serve. North Shore Healthcare is the Right Choice for you.
#J-18808-Ljbffr