Mds Care Plan Coordinator

Helia Healthcare•Olney, IL

About The Position

The MDS Care Plan Coordinator manages the integrity of the facility’s Resident Assessment Instrument (RAI) and Medicare processes. The role ensures that residents receiving Medicare services qualify for coverage, required continuing-stay documentation is completed, MDS/PPS assessments are timely and accurate under applicable regulations, and skilled nursing care continues as appropriate. The coordinator works within a nursing home and collaborates with residents, families, physicians, the interdisciplinary team, the Business Office Manager, and nursing leadership. The position also supports staff education, compliance with facility policies, and resident care as needed. The employee is required to be on call as needed by the facility.

Requirements

Current, valid state nurse license.
Functional literacy in English.
Proficiency in computer use and data entry.
No disqualifying criminal offenses as defined by regulatory guidelines.
Ability to communicate in English by phone, in writing, and verbally with staff at different levels, patient families, and outside customers.

Nice To Haves

Education and/or experience in long-term care, acute care, or geriatric nursing.
MDS/RAI experience.

Responsibilities

Obtain and maintain timely physician certifications for each Medicare resident.
Coordinate preparation of MDS assessments and care plans according to regulatory requirements, and update care plans as needed.
Maintain the MDS care plan schedule for the interdisciplinary team.
Invite residents and families to care plan meetings and assist residents in attending.
Assure daily assessment documentation for each Medicare resident and verify that it is appropriate and meets Medicare coverage guidelines.
Track Medicare benefit days, validate the daily Medicare census, and coordinate information with the Business Office Manager to support accurate billing.
Coordinate weekly Medicare meetings with the interdisciplinary team.
Work with the Social Service Director to keep residents and responsible parties informed about continuing or ending Medicare coverage.
Complete requests for additional information from the intermediary and appeals decisions within established time frames.
Assure Medicare denial letters are prepared for residents discharged from Medicare coverage within required time limits.
Participate in ongoing evaluation of documentation required for Medicaid reimbursement.
Monitor the appropriate MDS website for updates.
Submit MDS assessments to E-Health for analysis, correct them as needed, transmit assessments to the state repository according to regulatory guidelines, review validation reports, correct errors, and resubmit as needed.
Monitor nursing personnel’s compliance with Dart Chart documentation and maintain a RUG variance rate below 2% compared with DART Chart System calculations.
Function as a team leader and role model.
Ensure the attending physician and the resident’s family or responsible party are promptly notified of significant changes in the resident’s health.
Know and enforce responsibilities under the abuse prevention policy.
Assist with treatments, medications, and nursing services as needed.
Participate in ongoing staff education and orientation.
Support the Director of Nursing and Assistant Director of Nursing by ensuring nursing staff follow facility policies and procedures.
Be on call as needed by the facility.