MDS Director - Full-Time 1st Shift

Company: Willowcrest Health Services
Location: South Milwaukee
Posted on: January 26, 2023

Job Description:

NSHC1

Trust, engagement, competence, respect and passion - these are the values under which North Shore Healthcare operates every day. Our dedicated team of professionals strive to deliver quality care to our residents and their families. We are one of the leading employers and providers of post-acute care in the Midwest and we are seeking exceptional individuals to join our team. If you value being a leader, working in a progressive environment and having opportunities to grow in your career, North Shore Healthcare is the Right Choice for you.

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 accurately reflect the physical, mental and psychosocial status of each resident; ensures accuracy of RAI to reflect optimal reimbursement for services provided; ensures appropriate documentation to report and support services provided and assessment accuracy.

Essential Functions:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

* Oversees and coordinates the development and completion of the resident assessment (MDS) in accordance with current Federal and state regulations
* Coordinating and leading the development of a comprehensive resident assessment and care plan for each resident as chairperson of the center Interdisciplinary Plan of Care team
* Ensuring the face validity of all Minimum Data Sets before electronic submission
* Combine the timely electronic submission of all MDS
* Conducting a monthly review of a random sample of the MDS to ensure accuracy and internal consistency with the medical record
* Coordinate the completion of each resident's MDS in compliance with all State and Federal requirements
* Calculate triggers and develop resident assessment protocols for initiation of care plan
* Ensure MDSs are completed timely
* Accurately identify each resident's level of functioning in accordance with RAI manual guidelines
* Ensure each MDS accurately identifies the lowest level of functioning allowable to maximize reimbursement opportunities as allowed by Federal and State Law
* Ensure CNAs, nurses and other disciplines have accurately completed 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 according to State and Federal requirements and in compliance with center policies/procedures
* Review and assess all resident information (including hospital records) to accurately complete MDS scoring
* Train nursing staff on responsibilities for timely and accurate clinical record documentation


* Development
* Ensures Medicare claims relating to MDS pending and therapy pending errors are corrected
* Generate MDS audit reports as needed


* Implementation
* Verified Medicaid billing accuracy
* Verifies and maintains accurate billing for HMO and VA residents
* Compiles monthly and quarterly Medicare/Medicaid default reports
* Ensures MDS submission and report preparation, processing (CASPER, Validation Reports, etc.) and distribution
* Identifies MDS/Census and AR errors for corrections for center billing information
* Provides training on clinical software and Care Tracker


* Participates in interdisciplinary care team
* Stays current with state and federal regulatory changes
* Complies with laws and regulations applicable to position and act in accordance with Center's Compliance Program
* Attends and participates in in-service training, performance improvement ("PI") committees and other meetings as scheduled and directed
* Safety
* Knows and follows center rules
* Follows center dress and hygiene policies
* Demonstrates proper use of equipment. Reports equipment needs or repairs
* Follows center smoking policies
* Reports and documents any incidents or accidents of residents, staff or visitors to the appropriate center personnel
* Reports all hazardous conditions/equipment to Supervisor
* Performs duties, which may include transportation of residents, as assigned in Center Disaster Plan
* Uses required protective equipment
* Follows infection control standards, policies and procedures


* Resident Rights
* Knows Resident Rights. Helps the residents/patients exercise and/or protect their rights
* Reports resident/patient complaints to management
* Maintains confidentiality of resident/patient information


* HIPAA
* Follows and adheres to Center's policies and procedures implementing HIPAA requirements for the privacy and security of protected health information
* Uses and/or discloses only minimum amount of Protected Health Information necessary to complete assigned tasks
* Reports all suspected violation of company's HIPAA policies or procedures to Center Privacy Designee



Required Education and Experience

* Registered Nurse (RN) in good standing with respective state licensing board
* Clinical experience, education or specialty skills specific to geriatrics
* Demonstrated competence in PPS assessment as well as OBRA compliance
* Excellent clinical assessment skills
* Excellent organization and independent decision-making skills
* Knowledgeable and understands state and federal regulations and guidelines governing the practices of the center
* Excellent interpersonal skills
* Computer proficiency with Microsoft products

Preferred Education and Experience

* 2+ years of previous experience
* Experience in a fast-paced environment
* Post-acute care or health care experience preferred

Skills, Knowledge and Abilities:

Experience using MDS software computer system and software including proficiency in Microsoft Office Word and an email system. Strong oral and written communication skills. Strong organizational and project management skills. Ability to work with all levels of employees. Ability to read, write, speak and understand English. Ability to relate positively, effectively, appropriately with residents/patients, families, community members, volunteers and other center staff. Working knowledge of the MDS and RAI process with strong interest in Medicare, Medicaid, and other payor reimbursement systems. Demonstrates basic computer knowledge and ability with an aptitude 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 each of the communities we serve. We understand that choosing where you want to go in your career is a big decision. We would like the opportunity to show you that North Shore Healthcare is the Right Choice for you.

Our mission is to establish a culture that reinforces the values necessary to be the premier health services provider and employer in each of the communities we serve. We understand that choosing where you want to go in your career is a big decision. We would like the opportunity to show you that North Shore Healthcare is the Right Choice for you.

Keywords: Willowcrest Health Services, Milwaukee , MDS Director - Full-Time 1st Shift, Executive , South Milwaukee, Wisconsin