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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