Job Description

GENERAL SUMMARY:

Responsible for the coordination of the Resident Assessment Instrument (RAI), the electronic transmission of RAI data to the State Bulletin Board and the ongoing education of those preparing the MDS.   Demonstrates the knowledge to complete the RAI and above listed responsibilities and facilitates communication between the Interdisciplinary Team.

PRIMARY RESPONSIBILITIES AND DUTIES:

RAI Preparation and Process     

  1. Schedules completion of RAI following State and Federal guidelines.
  2. Notifies Interdisciplinary Team members with distribution of schedules showing dates of assessment schedules.
  3. Assists in completion of RAI as needed.
  4. Supervises the completion of the RAI by the Interdisciplinary Team.
  5. Modification to assessment schedule to ensure appropriate RUG score for each individual resident.
  6. Screens each Minimum Data Set (MDS) for accuracy before finalizing, locking and signing.
  7. Transmits RAI data to state weekly or as needed.
  8. Tracks Validation Reports, Monthly and Quarterly Reports from the State.

Medicare Review and Coverage    

  1. Review of each Medicare resident's case on the day of admission (excluding weekends) to ensure appropriateness of Medicare coverage.
  2. Active interaction with the Interdisciplinary Team in daily conference to evaluate each resident's status and needs relative to Medicare skilled coverage and potential for RUG category changes.
  3. Conducting daily Medicare review via chart audit in order to ensure that:
    1. Residents receive the care and services they need in a timely, cost-effective manner;
    2. Change of condition RAIs are initiated when appropriate;
    3. Review chart documentation, including nursing and ancillary progress notes, care plans and CNA notes, reflects the need for the care and services the resident receives;
    4. Medicare coverage is discontinued when resident no longer meets criteria.

Education

  1. Assist training of new personnel in RAI completion.
  2. Education updates to current staff.
  3. Evaluates own needs for personal and professional development to maintain high level of competence and practice.
  4. Utilizes the Internet for research and information gathering for changes in the RAI and Medicare process.

Care Planning

  1. Ensure that care plans are completed and updated to reflect an interdisciplinary approach to the resident's changing needs.

Continuous Quality Improvement

  1. Monitors RAI process.
  2. Develops plans for improvement of RAI process as needed.
  3. Weekly auditing a sample of assessments for accuracy.
  4. Maintains clinical competency in order to provide direct care as needed.
  5. Conducts self in a professional manner utilizing critical thinking in the resolution of problems.
  6. Performs other duties incidental to the position and as delegated by the Director of Nursing.

Other Duties

  1. Develop customized tracking tools and/or forms for interdisciplinary team members (i.e., D.O.N., Nurse Mgrs., Social Services)
  2. Assist multiple disciplines with computer usage, program assistance, technical errors and repairs of equipment.
  3. Answer call lights and assist with all other nursing duties.
  4. Ensure RAI/MDS software is functioning properly and is in contact with software vendor to ensure the facility is using the most current version of software.
  5. Clarification of Medicare Certification/Re-Certification forms for different disciplines.
  6. Assist with the completion and maintenance of the Resident Roster and the Census and Condition Reports.
  7. Works closely with the State RAI/MDS automation coordinator.
  8. Coordinates with the billing department on assessment schedules for effective date of assessments and clarification of billing assessment codes to complete the billing cycle in a timely manner.
  9. Confers with PAC on appropriateness of resident admissions.
  10. Assist D.O.N. with the verification and destruction of narcotics.
  11. Acts as a liaison to the Interdisciplinary Team.

BASIC QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

Save Job

More Jobs at Botsford Hospital Follow Company

See all jobs at Botsford Hospital