MDS Coordinator LPN / RN

Job Summary :

The MDS Coordinator is responsible for the accurate and timely completion of resident assessments and care plans in accordance with federal and state regulations. This role ensures compliance with CMS guidelines and supports the facility’s reimbursement processes through the management of the Minimum Data Set (MDS) system. The MDS Coordinator works collaboratively with nursing, therapy, dietary, and social services to ensure high-quality resident care and accurate documentation.

Essential Duties and Responsibilities

Works in collaboration with the Facility Rehab Manager to ensure the most appropriate assessment reference date (ARD) is utilized for Medicare assessments through the use of the PPS pathway.

Initiates direct and maintains the Medicare PPS / OBRA Assessment schedule to ensure timely completion of all assessments. Collaborates with the Interdisciplinary Team to set appropriate ARD for all assessments.

Ensures all new admissions have an MDS completed timely and accurately.

Ensures each Quarterly MDS is accurate, complete, and timely.

Ensures each Annual MDS assessments are accurate, complete, and timely.

Collaborates with Interdisciplinary Team to identify Significant Change in Status MDS.

In services and trains current and new staff in clinical reimbursement systems and issues, as identified.

Maintains a current knowledge base regarding State and Federal Regulations, PPS and the RAI Process.

Coordinates oversees and ensures the timely completion of the RAI process (MDS, CAA’s & Care Plan).

Leads and directs the Interdisciplinary Team in the Care Plan Process.

Manages communication with Managed Care and other payer sources.

Performs ongoing evaluation from pre-admission through discharge to ensure an appropriate reimbursement level for each resident. Evaluates care to ensure that services and products provided match the benefits available.

Reviews medical records, care plans, charting to ensure documentation supports the care provided and reimbursement level. Monitors facility practice to ensure compliance with guidelines for participation in Medicare, Medicaid, and other benefit programs. Initiates action needed to ensure compliance.

Reviews State MDS validation reports to identify issues and / or processes to ensure accuracy of submitted MDS’s.

Attends and participates in in-service training, Performance Improvement committees and meetings as scheduled and directed.

Certificates, Licenses, Registrations

Possesses a current license to practice in the State as an LPN / RN.