North Shore Health
MDS Director - Full-Time
Lake Country Health Services is a leading provider of skilled nursing and rehabilitation services. As part of North Shore Healthcare, we operate the largest post‑acute provider in the Upper Midwest with 70 skilled nursing and assisted living centers throughout Wisconsin, Minnesota, Michigan, and North Dakota.
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 accurately reflect the physical, mental and psychosocial status of each resident; ensures RAI accuracy for optimal reimbursement; ensures appropriate documentation to support services provided.
Essential Functions
Oversee and coordinate the development and completion of resident assessments (MDS) in accordance with current Federal and state regulations.
Lead the development of comprehensive resident assessment and care plans as chairperson of the center Interdisciplinary Plan of Care team.
Ensure the face validity of all Minimum Data Sets before electronic submission.
Combine timely electronic submission of all MDS.
Conduct monthly reviews of a random sample of MDS to ensure accuracy and internal consistency with the medical record.
Coordinate completion of each resident’s MDS in compliance with all state and federal requirements, including:
Calculating triggers and developing resident assessment protocols for care plan initiation.
Ensuring MDSs are completed timely and accurately reflect each resident’s level of functioning.
Maintaining accurate documentation by CNAs, nurses and other disciplines.
Coordinating and assisting with weekly interdisciplinary care conferences and Medicare meetings.
Making referrals to nursing and therapy departments.
Sustaining MDS and supporting clinical record documentation in compliance with policies and procedures.
Reviewing resident information, including hospital records, to accurately complete MDS scoring.
Training nursing staff on timely and accurate clinical record documentation.
Development responsibilities:
Ensuring Medicare claims related to MDS and therapy are corrected, and generating MDS audit reports as needed.
Implementation responsibilities:
Verifying Medicaid billing accuracy and maintaining accurate billing for HMO and VA residents.
Compiling monthly and quarterly Medicare/Medicaid default reports.
Ensuring MDS submission, report preparation, processing (CASPER, Validation Reports, etc.) and distribution.
Identifying MDS/Census and AR errors for corrections to center billing information.
Providing training on clinical software and Care Tracker.
Participating in interdisciplinary care teams.
Staying current with state and federal regulatory changes.
Complying with laws, regulations, and the Center’s Compliance Program.
Attending and participating in in‑service training, performance improvement committees, and other scheduled meetings.
Safety responsibilities:
Following center rules, dress and hygiene policies, and infection control standards.
Using proper equipment, reporting needs or repairs, and documenting incidents.
Reporting hazardous conditions and assisting with transportation duties as directed.
Resident Rights responsibilities:
Knowing Resident Rights and assisting residents in exercising those rights.
Reporting complaints to management and maintaining confidentiality of resident information.
HIPAA responsibilities:
Following Center’s HIPAA policies and procedures.
Using only the minimum amount of Protected Health Information necessary for assignments.
Reporting suspected HIPAA violations to the Center Privacy Designee.
Required Education And Experience
Registered Nurse (RN) in good standing with the respective state licensing board.
Clinical experience, education, or specialty skills specific to geriatrics.
Demonstrated competence in PPS assessment and OBRA compliance.
Excellent clinical assessment, organizational, and independent decision‑making skills.
Knowledge of state and federal regulations governing the center’s practices.
Excellent interpersonal skills.
Computer proficiency with Microsoft products.
Preferred Education And Experience
2+ years of previous experience.
Experience in a fast‑paced environment.
Post‑acute care or health care experience preferred.
Skills, Knowledge and Abilities Experience using MDS software and Microsoft Office; strong oral and written communication; strong organizational and project management skills; ability to work with all levels of staff; proficiency in English; positive engagement with residents, families, and staff; working knowledge of the MDS and RAI process with interest in Medicare, Medicaid, and payor reimbursement systems; basic computer knowledge and learning aptitude.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Business Development and Sales
Industries Hospitals and Health Care
Our mission is to establish a culture that reinforces the values necessary to be a premier health services provider and employer in each community we serve. We understand that choosing where you want to go in your career is a big decision. We would like the opportunity to show you that North Shore Healthcare is the Right Choice for you.
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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 accurately reflect the physical, mental and psychosocial status of each resident; ensures RAI accuracy for optimal reimbursement; ensures appropriate documentation to support services provided.
Essential Functions
Oversee and coordinate the development and completion of resident assessments (MDS) in accordance with current Federal and state regulations.
Lead the development of comprehensive resident assessment and care plans as chairperson of the center Interdisciplinary Plan of Care team.
Ensure the face validity of all Minimum Data Sets before electronic submission.
Combine timely electronic submission of all MDS.
Conduct monthly reviews of a random sample of MDS to ensure accuracy and internal consistency with the medical record.
Coordinate completion of each resident’s MDS in compliance with all state and federal requirements, including:
Calculating triggers and developing resident assessment protocols for care plan initiation.
Ensuring MDSs are completed timely and accurately reflect each resident’s level of functioning.
Maintaining accurate documentation by CNAs, nurses and other disciplines.
Coordinating and assisting with weekly interdisciplinary care conferences and Medicare meetings.
Making referrals to nursing and therapy departments.
Sustaining MDS and supporting clinical record documentation in compliance with policies and procedures.
Reviewing resident information, including hospital records, to accurately complete MDS scoring.
Training nursing staff on timely and accurate clinical record documentation.
Development responsibilities:
Ensuring Medicare claims related to MDS and therapy are corrected, and generating MDS audit reports as needed.
Implementation responsibilities:
Verifying Medicaid billing accuracy and maintaining accurate billing for HMO and VA residents.
Compiling monthly and quarterly Medicare/Medicaid default reports.
Ensuring MDS submission, report preparation, processing (CASPER, Validation Reports, etc.) and distribution.
Identifying MDS/Census and AR errors for corrections to center billing information.
Providing training on clinical software and Care Tracker.
Participating in interdisciplinary care teams.
Staying current with state and federal regulatory changes.
Complying with laws, regulations, and the Center’s Compliance Program.
Attending and participating in in‑service training, performance improvement committees, and other scheduled meetings.
Safety responsibilities:
Following center rules, dress and hygiene policies, and infection control standards.
Using proper equipment, reporting needs or repairs, and documenting incidents.
Reporting hazardous conditions and assisting with transportation duties as directed.
Resident Rights responsibilities:
Knowing Resident Rights and assisting residents in exercising those rights.
Reporting complaints to management and maintaining confidentiality of resident information.
HIPAA responsibilities:
Following Center’s HIPAA policies and procedures.
Using only the minimum amount of Protected Health Information necessary for assignments.
Reporting suspected HIPAA violations to the Center Privacy Designee.
Required Education And Experience
Registered Nurse (RN) in good standing with the respective state licensing board.
Clinical experience, education, or specialty skills specific to geriatrics.
Demonstrated competence in PPS assessment and OBRA compliance.
Excellent clinical assessment, organizational, and independent decision‑making skills.
Knowledge of state and federal regulations governing the center’s practices.
Excellent interpersonal skills.
Computer proficiency with Microsoft products.
Preferred Education And Experience
2+ years of previous experience.
Experience in a fast‑paced environment.
Post‑acute care or health care experience preferred.
Skills, Knowledge and Abilities Experience using MDS software and Microsoft Office; strong oral and written communication; strong organizational and project management skills; ability to work with all levels of staff; proficiency in English; positive engagement with residents, families, and staff; working knowledge of the MDS and RAI process with interest in Medicare, Medicaid, and payor reimbursement systems; basic computer knowledge and learning aptitude.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Business Development and Sales
Industries Hospitals and Health Care
Our mission is to establish a culture that reinforces the values necessary to be a premier health services provider and employer in each community we serve. We understand that choosing where you want to go in your career is a big decision. We would like the opportunity to show you that North Shore Healthcare is the Right Choice for you.
#J-18808-Ljbffr