Job Description

Position Summary

• Responsible for the coordination of the Resident Assessment Instrument (RAI), the electronic transmission of RAI data to the state Bulletin Board in accordance with State and Federal regulations and facility policies.
• Facilitates communication between the Interdisciplinary Team.
• Ongoing education of those preparing the M.D.S.

Essential Duties & Responsibilities

1. RAI Preparation and Process

1. Schedules completion of RAI following State and Federal guidelines.
2. Notifies Interdisciplinary Team members with distribution of schedules showing dates of assessment schedules.
3. Assists in completion of RAI as needed.
4. Assists with data input into the RAI computer system.
5. Supervises the completion of the RAI by the Interdisciplinary Team.
6. Modification to assessment schedule to ensure appropriate RUG score for each individual resident.
7. Screens each Minimum Data Set (MDS) for accuracy before finalizing, locking, and signing.
8. Transmits RAI data to the state weekly or as needed.

I. Tracks Validation Reports, Monthly and Quarterly Reports from the state.

II. Medicare Review and Coverage

1. Active interaction with the Interdisciplinary Team in daily conference to evaluate each resident's status and needs relative to Medicare skilled coverage and potential for RUG category changes.
2. Assist Interdisciplinary staff with Medicare review via chart audit in order to ensure that:

1. Change of condition RAIs are initiated when appropriate;
2. Review chart documentation, including nursing and ancillary progress notes, care plans, and CNA notes, reflects the need for the care and services the resident receives;

3. Medicare coverage is discontinued when resident no longer meets criteria.

III. Other Duties

1. Develop customized tracking tools and/or forms for interdisciplinary team members (i.e. D.O.N., A.D.O.N., Nurse managers, Social Services)
2. Ensures RAI/MDS software is functioning properly and is in contact with software vendor to ensure that facility is using the most current version of software.
3. Clarification of Medicare Certification/Re-Certification forms for different disciplines. Assist with the completion and maintenance of the Resident Roster and the Census and Condition Reports.
4. Works closely with the state RAI/MDS automation coordinator.
5. Coordinates with the billing department on assessment schedules for effective date of assessments and clarification of billing assessment codes to complete the billing cycle in a timely manner.
6. Utilizes the Internet for research and information gathering for changes in the RAI and Medicare process.
7. Acts as a liaison to the Interdisciplinary Team.

H. Performs other duties incidental to the position and as delegated by the Director of Nursing.

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