MDS Nurse

PACS

3d•$42 - $47•Onsite

About The Position

Western Slope Healthcare Center is seeking a detail-oriented and compassionate MDS Nurse (LVN/LPN) to join our team in Placerville, California. The MDS Nurse plays a critical role in ensuring accurate resident assessments, comprehensive care planning, regulatory compliance, and appropriate reimbursement. This position works closely with nursing, therapy, dietary, social services, and other interdisciplinary team members to ensure each resident's needs are accurately assessed and addressed. If you are an organized nursing professional who takes pride in clinical accuracy, regulatory compliance, and quality resident care, we would love to hear from you!

Requirements

Current, active LVN/LPN license in the state of practice.
Prior experience in a long-term care or skilled nursing facility preferred.
Previous MDS/RAI experience strongly preferred.
Working knowledge of MDS 3.0, the RAI process, Care Area Assessments (CAAs), and Medicare/Medicaid reimbursement guidelines.
Knowledge of skilled nursing facility clinical documentation and care planning requirements.
Strong organizational skills with exceptional attention to detail and accuracy.
Ability to prioritize multiple assignments and meet required regulatory deadlines.
Ability to work effectively and collaboratively with an interdisciplinary team.
Proficiency with electronic health records (EHR) systems.
Proficiency with Microsoft Office/Microsoft Suite products.
Ability to maintain confidentiality and exercise sound professional judgment.
Must be able to read, write, speak, and understand the English language.
Ability to read and understand technical procedures, policy and procedure manuals, regulatory guidance, and other written materials related to resident care and MDS requirements.
Ability to effectively communicate information and respond to questions from residents, families, managers, employees, and members of the interdisciplinary team.
Must be able to effectively communicate information concerning a resident's condition, care needs, treatment, and progress.
Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Ability to understand and interpret basic clinical and reimbursement-related calculations and information.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Ability to interpret and follow a variety of instructions furnished in written, oral, diagram, or schedule form.
Ability to analyze resident information, identify discrepancies or missing documentation, and determine appropriate follow-up.
Ability to exercise sound judgment and make decisions consistent with applicable regulations, professional standards, and facility policies.
Current and active LVN/LPN license in the state of practice is required.
Must maintain all required continuing education and professional licensing requirements.
Must remain in good standing with the applicable State Board of Nursing at all times.
Must maintain any required MDS/RAI training or certifications.
Must be proficient in Microsoft Office/Microsoft Suite products.

Nice To Haves

Additional MDS-related education or certification is preferred.

Responsibilities

Complete MDS assessments and Care Area Assessments (CAAs) within required timelines.
Ensure accuracy and completeness of resident clinical documentation to support individualized care planning and reimbursement.
Maintain compliance with CMS, state, federal, and facility guidelines.
Coordinate the RAI/MDS process from assessment through completion and submission.
Collaborate with interdisciplinary team members to develop and maintain individualized resident care plans.
Monitor resident progress and update care plans as appropriate.
Participate in resident care conferences and interdisciplinary team meetings.
Ensure MDS submissions meet regulatory requirements for Medicare and Medicaid reimbursement.
Assist with internal and external audits, regulatory surveys, and record reviews by providing accurate documentation and reports.
Stay current with changes to CMS regulations, RAI guidelines, MDS requirements, and skilled nursing documentation standards.
Work closely with nursing staff, therapy, social services, dietary, activities, and other departments to gather accurate and comprehensive resident information.
Review clinical documentation for consistency, completeness, and accuracy.
Identify discrepancies or missing information and work with appropriate departments to obtain clarification or correction.
Provide education and guidance to nursing and other staff regarding documentation standards, MDS requirements, and care planning.
Communicate effectively with residents and families regarding assessments, care planning, and resident needs.
Maintain confidentiality of resident and facility information in accordance with HIPAA and facility policies.
Participate in quality assurance and performance improvement (QAPI) activities as assigned.
Maintain accurate records and documentation in accordance with facility policies and regulatory requirements.
Perform other duties as assigned by facility leadership.