St. Luke Health Services
Job Overview
This MDS Nurse collects and assesses information for the health and well‑being of residents in Medicare or Medicaid‑certified beds. Complies with Federal and State requirements for all MDS sections and follows facility policy and procedures. The MDS Nurse monitors residents’ health and well‑being from admission until the end of their stay and assists with Quality Assurance and quality measures.
Responsibilities
Completes the nursing components of the Resident Assessment Instrument (RAI) process to ensure timely completion of Minimum Data Set.
Ensures completion of PPS and/or OBRA assessments for both sub‑acute and long‑term care as required.
Utilizes State and Federal guidelines for the RAI process ensuring documentation meets necessary guidelines and reimbursement standards.
Gathers information from nursing, dietary, social services, therapy, and physician services to ensure appropriate quality of care and reimbursement.
Assists with completing nursing assessments.
Ensures legal compliance for the facility by following the MDS Process.
Assists with determination coverage for skilled Nursing services and provides the team with documentation information to prevent payment denials.
Utilizes the RAI, MDS 3.0, QM and QRP manuals to ensure the highest quality of care is provided, documentation supports outcomes and maximum reimbursement is achieved.
Reviews 24‑hour report for updates and possible change of condition.
Assists with the Quality Assurance Program as needed.
Participates in daily review of new admission medical record, MD orders and nursing reports.
Ensures compliance with regulations utilizing the MDS schedule to plan and set MDS ARD.
Maintains and develops ongoing MDS schedule.
Audits and analyzes MDS data for accuracy.
Works in collaboration with Unit Managers and unit staff for educational purposes and accuracy of documentation.
Educates members of the IDT as necessary in completion of the MDS and any changes in the MDS process.
Attends weekly Medicare meeting to ensure that eligible residents receive Medicare coverage and that documentation is in the medical record.
Works with residents and families regarding questions on Medicare benefits and related issues.
Issues NOMNC to residents/responsible party and assists with the appeals process, as needed.
Completes QA audits as assigned.
Recognizes link between MDS data and Quality Improvement measures.
Maintains open communication with Medical Staff, Administrator, DON, ADON and Pharmacy consultant.
Attends Nurse Management meetings, Patient Care meetings and any other meetings as assigned.
Performs other tasks as assigned.
Qualifications
Current NYS Licensed Registered Nurse.
Knowledge of MDS 3.0, CAA’s, Medicare and Medicaid Guidelines for coverage and reimbursement.
RAC‑CT Certification preferred.
Excellent written and oral communication skills with the ability to work independently and under time constraints.
Long‑Term Care Experience.
Basic computer skills.
Requirements Must be able to work more than eight (8) hours per day or more than forty (40) hours per week.
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Responsibilities
Completes the nursing components of the Resident Assessment Instrument (RAI) process to ensure timely completion of Minimum Data Set.
Ensures completion of PPS and/or OBRA assessments for both sub‑acute and long‑term care as required.
Utilizes State and Federal guidelines for the RAI process ensuring documentation meets necessary guidelines and reimbursement standards.
Gathers information from nursing, dietary, social services, therapy, and physician services to ensure appropriate quality of care and reimbursement.
Assists with completing nursing assessments.
Ensures legal compliance for the facility by following the MDS Process.
Assists with determination coverage for skilled Nursing services and provides the team with documentation information to prevent payment denials.
Utilizes the RAI, MDS 3.0, QM and QRP manuals to ensure the highest quality of care is provided, documentation supports outcomes and maximum reimbursement is achieved.
Reviews 24‑hour report for updates and possible change of condition.
Assists with the Quality Assurance Program as needed.
Participates in daily review of new admission medical record, MD orders and nursing reports.
Ensures compliance with regulations utilizing the MDS schedule to plan and set MDS ARD.
Maintains and develops ongoing MDS schedule.
Audits and analyzes MDS data for accuracy.
Works in collaboration with Unit Managers and unit staff for educational purposes and accuracy of documentation.
Educates members of the IDT as necessary in completion of the MDS and any changes in the MDS process.
Attends weekly Medicare meeting to ensure that eligible residents receive Medicare coverage and that documentation is in the medical record.
Works with residents and families regarding questions on Medicare benefits and related issues.
Issues NOMNC to residents/responsible party and assists with the appeals process, as needed.
Completes QA audits as assigned.
Recognizes link between MDS data and Quality Improvement measures.
Maintains open communication with Medical Staff, Administrator, DON, ADON and Pharmacy consultant.
Attends Nurse Management meetings, Patient Care meetings and any other meetings as assigned.
Performs other tasks as assigned.
Qualifications
Current NYS Licensed Registered Nurse.
Knowledge of MDS 3.0, CAA’s, Medicare and Medicaid Guidelines for coverage and reimbursement.
RAC‑CT Certification preferred.
Excellent written and oral communication skills with the ability to work independently and under time constraints.
Long‑Term Care Experience.
Basic computer skills.
Requirements Must be able to work more than eight (8) hours per day or more than forty (40) hours per week.
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