MDS/Restorative Nurse

About the Role

The MDS Coordinator / Restorative Nurse is responsible for the accurate and timely completion of all Medicare/Medicaid case-mix documents to assure appropriate reimbursement for care and services provided within the facility. This role conducts continual Minimum Data Set (MDS) reviews to achieve optimal allowable Resource Utilization Group (RUG) category, oversees the MDS/Prospective Payment System (PPS) documentation and submission process, and integrates nursing, dietary, social recreation, restorative, rehabilitation, and physician services. Additionally, the incumbent develops, implements, monitors, and supervises the restorative nursing program, acting as a liaison between formalized therapy and nursing while promoting a restorative nursing philosophy among facility departments.

Responsibilities

• Assesses and determines the health status and level of care of all new admissions.
• Ensures the accurate and timely completion of all MDS assessments including PPS Medicare, quarterly, annual, and significant change assessments.
• Communicates level of care for new residents to all disciplines.
• Coordinates interdisciplinary participation in completing the MDS for each new admission and resident according to regulatory time frames, ensuring completeness and thoroughness of documentation.
• Maintains an accurate schedule of all MDS assessments, including proper reference dates throughout the resident’s stay.
• Responsible for data entry and electronic submission of MDS assessments, verifying submissions and performing corrections as necessary.
• Schedules and conducts resident care conferences in compliance with state and federal regulations, ensuring completion of all MDS reviews prior to conferences.
• Assists disciplines in formulating and revising care plans, ensuring resident’s present and potential problems are identified, prioritized, and addressed with appropriate nursing interventions.
• Evaluates resident care plans for comprehensiveness and individuality, reassessing and revising as needed.
• Responsible for all level of care changes within the facility, notifying all departments and transmitting necessary forms to appropriate agencies.
• Assists in developing, organizing, and implementing nursing care philosophy, objectives, policies, procedures, and standards.
• Confers with the Director of Nursing/Assistant Director of Nursing to assess and improve the quality of nursing care.
• Makes daily rounds to evaluate patient care, monitor nursing practices, and assist with educational needs.
• Performs rehabilitation assessments for new admissions and existing patients on a quarterly basis and as needed.
• Performs or oversees functional evaluations and consults with nurses to develop restorative plans of care.
• Ensures all restorative nursing measures are reflected on the care plan.
• Works closely with the therapy department to ensure continuity of care post-therapy discharge.
• Reviews weekly documentation for residents receiving restorative services and ensures proper ADL documentation.
• Oversees incontinent management programs.
• Attends care planning conferences, QAPI meetings, and provides feedback on restorative service needs.
• Coordinates with Human Resources and the Director of Nursing to orient and educate new and existing staff on restorative nursing principles and practices.
• Actively participates in physical restraint reduction and fall management programs.
• Sets up documentation flow sheets for daily restorative nursing measures.
• Performs or supervises restorative nursing staff and serves as a liaison with all therapists.
• Participates in patient care planning and CMI meetings.
• Serves as Medicare Services Coordinator (MDS Coordinator) as needed.
• Prioritizes patient and family needs, ensuring high-quality service in a caring and compassionate atmosphere.
• Performs other duties as assigned.

Qualifications

• RN or LPN with current unencumbered state license.
• 3–5 years of equivalent clinical experience.
• Current CPR certification.
• Long-term care experience preferred.
• Ability to read, write, speak, and understand the English language.

Physical Demands

The physical demands described are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities.

• Required to sit, stand, bend, and walk regularly.
• Lift and/or move up to 25 pounds.
• Visual and auditory ability sufficient for written and verbal communication.
• The noise level in the work environment is usually moderate.