PASRR Nurse

TX-HHSC-DSHS-DFPS•Mexia, TX

11d•Hybrid

About The Position

The Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) division seeks a highly qualified candidate to fill the position of Nurse III in the Quality Monitoring Program (QMP). MCS is driven by its mission to deliver quality, cost-effective services to Texans. This position makes a significant contribution to MCS’s mission by performing senior-level consultative services and technical assistance work to include: providing guidance in the planning, development, coordination, and implementation of Quality Monitoring Program (QMP) initiatives and procedures; functioning as a liaison with internal and external stakeholders, assisting with critical projects; conducting monitoring visits and providing guidance relevant to the federally mandated Pre-Admission Screening and Resident Review (PASRR) Medicaid program to Texas nursing facilities. In addition, this position will assist with the provision of education to nursing facility staff and others as it relates to quality improvement and effective compliance with federal and state PASRR regulations. This position works under the direct supervision of the PASRR Manager within QMP, with considerable latitude for the use of initiative and independent judgment. The PASRR Nurse III conducts onsite monitoring visits, both independently and as part of a team, to ensure compliance to the program standards and implementation of Medicaid laws and regulations relevant to the federally mandated PASRR Medicaid program. This includes independently conducting medical record reviews and onsite quality monitoring visits to nursing facilities to ensure that persons with intellectual or developmental disability (IDD) and mental illness have been appropriately screened and evaluated; are placed in the least restrictive residential setting to meet their needs; and are receiving the specialized services needed to maximize the individual’s potential. The PASRR Nurse III performs a review of elements of an individual’s medical record, any relevant documents, interviews nursing facility staff, interviews residents, and observes the individual engaged in activities or receiving necessary services and supports as specified in the PASRR Comprehensive Service Plan (PCSP) and Nursing Facility Comprehensive Care Plan (NFCPC). The PASRR Nurse III must use independent, professional judgment in determining if PASRR systems are providing services as outlined in the PCSP, providing educational consultation, producing accurate quality assurance, and assist in providing orientation to peers and others as needed. This position must be able to apply their complex knowledge of nursing practice, their critical thinking skills as well as the rules outlined in the Texas Nursing Practice Act. The Nurse III will be familiar with local, state, and federal laws and regulations relevant to long-term care as well as program standards and Medicaid laws and regulations relevant to the federally mandated PASRR Medicaid program. The position will be responsible for assisting with the development and updating of program policies and procedures, educational programs, documenting complete and accurate reports, monitoring visit activities, and communicating pertinent information regarding visits with the Manager. Performs other duties as assigned.

Requirements

Current Texas Registered Nurse license (in good standing).
Minimum two (2) years of experience working with persons with IDD.
Experience making oral presentations and providing educational consultation.
Willing to travel 80% of the time.
Ability to work collaboratively across MCS to accomplish objectives.
Ability to implement creative solutions to problems.
Ability to balance team and individual responsibilities.
Knowledge of nursing facility policies and services provided.
Knowledge of PASRR program rules and services provided.
Ability to evaluate the quality of services for persons with an IDD.
Skilled in public speaking and presentations.
Skilled in complaint resolution.
Knowledge of best clinical practices in programs that serve persons with IDD.
Ability to write clearly and concisely, using correct grammar and punctuation.
Ability to make oral presentations.
Skilled in the use of computers, preferably in a PC, or Windows-based operating environment.
Skilled in understanding complex federal regulations.
Skill in organizing resources and establishing priorities.
Ability to operate and drive a vehicle.
Ability to perform other essential job functions such as sitting, standing, crawling, kneeling, bending, and lifting to 25 lbs.
Current Texas driver’s license.

Nice To Haves

BSN or higher preferred, but not required.

Responsibilities

Prioritizes, plans and performs a variety of technical assistance, research, review of facility policies and programs, and administrative activities during off-site and on-site Quality Monitoring and Rapid Response Team (RRT) visits, including assessment of the delivery of services and other actions necessary to review individual nursing services and activities, programming records, and other relevant documentation of the supports and services the individual is receiving to ensure most effective compliance with federal and state PASRR regulations and according to departmental standards. As a member of the RRT, using their clinical expertise through observations, record reviews and interviews, shares the findings with other team members and assists the nursing home provider in developing action plans for the areas needing improvement to meet minimal standards. Conducts debriefings with program provider staff related to PASRR and PASRR quality assurance.
Communicates on a complex level with others (internally or externally; for example, facility staff, contractors, HHSC program staff) to provide, exchange, or verify information, answer inquiries, and address issues related to PASRR and PASRR quality reviews. Serves as a resource on nursing practices and education programs by performing educational and consultative work. Provides complex technical assistance to others (for example, facility staff, contractors, HHSC program staff) on PASRR policies, procedures, rules, regulations, standards, or requirements. Communicates accurate information, findings, recommendations, and technical assistance to the facility staff. Disseminates appropriate education tools and materials and provides high-level technical assistance to providers’ staff; and creates efficiencies where opportunities occur.
Documents on-site review findings and interview discussions used to determine recommendations for quality improvement and effective compliance with federal and state PASRR regulations. Completes quality assurance ratings and prepares written reports, as needed, supporting the actions and remedies recommended.
Schedule visits to nursing facilities where the quality service review will occur. Tracks, and monitors situations requiring follow-up, plans, coordinates, or schedules activities on a complex level to ensure task deadlines and program needs are met.
Research inquiries or complaints, recommends resolutions, and prepares responses.
Maintains current knowledge in assigned area by reviewing program policies and procedures, guidance documents, conducting literature reviews and synthesizing the information to share with others. Attends meetings or seminars, or educational opportunities as assigned to maintain current knowledge.