MDS Nurse

General Description

MDS (Minimum Data Set) 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. Follows facility policy and procedures. The MDS Nurse monitors residents' health and well-being from the time of admission through the end of their stay. Assist with Quality Assurance and quality measures.

Responsible To

Administrator

Duties and 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 subacute and long-term care as required.
• The MDS Nurse 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.
• MDS Nurse will assist with completing nursing assessments.
• Ensure legal compliance for the facility by following the MDS Process.
• Affords assistance with determination coverage for skilled Nursing services and provides complete 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.
• Affords assistance 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 on-going MDS schedule.
• Audits and analyzes MDS data for accuracy.
• Works in collaboration with the 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 as appropriate and ensures appropriate documentation is in medical record.
• Works with residents, families as needed regarding questions on Medicare benefits and related issues (demand bill).
• Issues NOMNC to residents/responsible party and affords assistance 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