Positions Summary: Coordinates the completion of Minimum Data Sets (MDS) and associated processes in the development of the individualized plan of care and the maximum reimbursement for each resident. Chairs care plan meetings.
Responsible for submission of case mix data.
Essential Duties and Responsibilities: Coordinates mandated RAI process
Responsible for ensuring accuracy of individual/facility case mix indices.
Accountable for the coordination of documentation supporting the RAI and PPS process. Provides any requested information to Billing Representatives .
Schedules and coordinates the completion of RAI forms. Ensures that assignments are given to appropriate interdisciplinary staff and that schedules are established/distributed for RAI, PPS and care plan completion/review according to CMS regulations.
Chairs care plan review and ensures progress notes for each resident are entered by a social worker.
Ensures MDS data is supported with documentation on the clinical record and accurately reflects the resident's current status.
Monitors 24- hour condition report for potential significant change in resident condition.
Ensures Case Mix and PPS submissions are correct and free of errors. Reviews supporting documentation and updates it as necessary.
Responsible for transmission and submission of case- mix and PPS documentation to the state.
Conducts weekly Medicare meetings.
Reviews residents' continuing needs for SNF services and acuity level when there is a change in residents' conditions. Assures that call all call bells are answered promptly, meeting all residents' needs in a timely manner.
Reports incidents, accidents or changes in condition to the RN Supervisor immediately. Strictly adheres to infection control and safety rules, regulations, policies and procedures
Maintains the confidentiality of all resident care information, including protected health information in accordance with HIPAA and other federal and state regulations.
Performs all tasks and duties in an efficient and safe manner.
Performs other related duties as assigned or as necessary. Remains flexible and adaptable in work schedules and work assignments as defined by departmental and facility needs.
Represents the facility in a manner that conveys professionalism, confidentiality, courtesy, fairness, personal integrity, and respect for the fundamental rights, dignity, personal comfort and privacy of others.
Required Competencies: QUALITY & PRODUCTIVITY Provides high quality services, processes and programs while consistently seeking ways to improve outcomes and enhance the facility. Meets or exceeds goals and objectives and consistently engages in productive work effort requiring, minimal direction from manager.
PROFESSIONALISM Demonstrates self-control by maintaining composure in difficult situations; deals calmly and effectively with stressful situations. Projects a professional image of oneself and the organization and demonstrates a positive attitude towards work and the organization.
ACCOUNTABILITY Demonstrates commitment to the position and accepts responsibility for personal actions. COLLABORATION & TEAMWORK
Supports a positive team environment in which employees participate, respect and cooperate with each other to achieve desired results. Builds and sustains cooperative working relationships and demonstrates a positive attitude in work assignments and interaction with others.
COMMUNICATION Expresses self in a knowledgeable, coherent, and professional manner. Works to resolve conflict and promotes an open and honest environment for feedback and constructive criticism.
LEADERSHIP Provides direction and motivation and sets an example through open communication and modeling best practices. Provides appropriate advice, on- going feedback, support and resources to improve effectiveness of individuals and departments.
Qualifications: EDUCATION AND/OR EXPERIENCE 3 years previous experience in a nursing home with a strong focus in rehabilitative service programs preferred. Must have an understanding of the RAI and PPS process with a demonstrated capacity for leadership. Knowledge of clinical practices and procedures as well as laws, regulations and guidelines that pertain to long term care. Must be able to effectively communicate with older adults in a manner that conveys warmth and professionalism LICENSURE AND/OR CERTIFICATION RN/LPN with current active licensure in the practicing State
