Overview

SUMMARY: The MDS Director is responsible for coordinating the MDS responsibilities between the MDS Coordinators and the Interdisciplinary team involved in the RAI process in the center as well as performing MDS Coordinator functions to ensure all requirements of the department are met timely and accurately.

Responsibilities

ESSENTIAL FUNCTIONS:

MDS Director related duties:

• Workload assignments and caseload management among the centers’ MDS Coordinators.
• Ensuring that he/she or designee MDS Coordinator is in attendance at key meetings including but not limited to Morning standup, Clinical & IDT meetings, and QAPI.
• Ensuring that MDS’s are opened and ARD’s for assessments are set timely, MDS data encoding is completed timely, care plan reviews are opened and closed timely.
• Establishing MDS completion priorities in the center based on billing, regulatory and other pertinent timelines.
• In conjunction with the Regional Clinical Reimbursement Specialist and RAI Director, monitoring timeliness and accuracy of MDS and CAA completion by the interdisciplinary team and support and education are provided timely when needs are identified.
• Monitoring and implementing reimbursement optimization opportunities within regulatory and compliance guidelines.
• With assistance from the corporate Clinical ADR/Medical Review Coordinator, ensuring timely and accurate ICD10 diagnosis coding by the MDS coordinators.
• Promptly communicating personnel issues, staff performance, and workload/staffing capacity concerns relative to the RAI process to the Administrator.
• Communicate frequently with and coordinate with Regional Clinical Reimbursement Specialists.

Human Resources MDS Coordinator related duties:

• Provide leadership to interdisciplinary team for management of the MDS and Care Plan process and input to utilization management processes in accordance with current federal, state, and local requirements and regulations.
• Ensure the timeliness and accuracy of assessment completion.
• Making informed decisions regarding MDS item set coding judgements based on the clinical data available to accurately reflect the patient/resident status, especially when some data may be conflicting.
• Understand the wide financial impact of adequately and accurately capturing all services provided to or needed by patients/residents and the potential negative financial, regulatory, and legal implications to the organization and individuals if this outcome in not achieved.
• Ensure that disciplines that care for and assess the patient/resident actively and accurately understand and participate in the RAI process.
• Assist center Leadership with Qualify Improvement efforts, staff education, and regulatory compliance as it relates to the RAI process, Quality care, and Reimbursement.
• Assist the center in determining and assessing level of care for new and ongoing residents in accordance with Skilled Care Criteria as outlined by federal, state, and local payers.
• General oversight of related care processes.
• Coordinates and participates in the completion of MDS assessments, triggers, CAA’s and comprehensive plans of care via review of the resident’s medical record, communication with and observation of the resident, communication with direct care staff, communication with the resident’s physician, and communication with the resident’s family and Interdisciplinary team.
• Complete portions of the MDS, CAA’s, and Care plans as required to ensure timely and accurate completion.
• Maintains a schedule/calendar for all skilled and non-skilled residents and provides the calendar to members of the interdisciplinary care team members sufficiently prior to the dates the assessments are due to allow for timely and accurate assessment completion.
• Coordinates with all disciplines the establishment of the most appropriate common assessment reference period to accurately reflect the patient’s/resident’s status and resources necessary to care for the patient/resident.
• Ensures that interdisciplinary assessments and care plan development and updates are completed using common assessment periods within the time frames established by State and Federal guidelines and Commonwealth Care policies.
• Ensures the interdisciplinary assessment team utilizes appropriate resident assessments and triggered CAA’s in the development of a comprehensive, interdisciplinary plan of care reflecting the resident’s current physical, mental, and psychosocial needs.
• Ensures that documentation relative to the resident assessment process is maintained according to Medicare/Medicaid, State/Federal Guidelines, and Commonwealth Care policy and procedures.
• Enforces accurate and timely Resident assessments according to state and federal regulations.
• Completes the attestation and locks the assessment prior to submitting assessments.

Human Resources

• Provides educational training correlating to the resident assessment/care plan/MDS process to the ID team as needed.
• Works with the administrator to assure CMI scores are an accurate reflection of the facility’s residents using corporate tools for the accuracy measurement.
• Demonstrates the ability to assess, plan, implement, and evaluate all aspects care; including physical, mental, and emotional status. Facilitate the implementation of any required interventions.
• Demonstrates the ability to communicate effectively with family members regarding resident’s care and/or condition.
• Demonstrates the ability to address complaints, follow up and keep administration informed.
• Performs other duties within the scope of the education and experience as assigned which may include oversight of related care processes.
• Attends clinical morning meeting, morning stand up meeting, at risk meetings, fall team meeting, pressure ulcer meeting, weight loss meeting and other resident related meetings as appropriate or directed to develop an appropriate plan of care, or make revisions to the existing care plan based on the changes in the resident’s condition.
• Contributes and assists in leading meetings relevant to Clinical Reimbursement by coordinating with the team members to discuss progress, condition changes and discharge disposition of Medicare Part A and Managed care stays and other resident stays as appropriate.
• Ensuring the timeliness and accuracy of assessment completion.
• Promote and demonstrate a Service Excellence culture.
• Perform other duties as assigned.