MEDICARE NURSE - Care Choice of Boerne

1. Makes rounds of Medicare patients at least daily.
2. Works closely with admissions to assess all inquiries for possible Medicare admissions.
3. Visits or arranges for the visit of an appropriate clinical representative to pre-screen potential patients for admission and readmission to the facility.
4. Screens all new admits and readmissions for skilled care in accordance with facility policies and procedures.
5. Interacts with discharge planners and staff from referring facilities, agencies and hospitals to pre-screen potential patients for admission and readmission to the facility.
6. Responsible for skilled nursing documentation on Medicare patients, either through actual documentation or audits.
7. Responsible for all required nursing documentation for Medicare nursing to include any other record keeping required by the program for nursing.
8. Assesses Medicare residents for continued stay on continuous basis and tracks remaining days in unit.
9. Manage and collaborates with the MDS Team on pre-admission screening, assignment of observation and look-back periods; informs the interdisciplinary team regarding changes in look-back periods for the MDS completion including the implementation of a “significant change” MDS/plan of care processes.
10. Assigns the admission RUG category for payment for the initial five day Medicare MDS in collaboration with the MDS Team.
11. Establishes individual MDS schedules and coordinates assessment activities across clinical disciplines for each patient following regulatory requirements.
12. Ensures the MDS’s are encoded, edited, locked and electronically transmitted within the required time frames.
13. Initiates and coordinates patient discharge plan upon admission to the facility in collaboration with the social services, admissions, clinical team, patient and facility.
14. Performs a nursing physical and psychosocial MDS assessment on all patients and reassessments as per the MDS scheduled requirements unless these are assigned to other clinical disciplines for completion.
15. Determines the RUG categories of Medicare payments for patients based upon the MDS assessments and in collaboration with the MDS team.
16. Reviews and sends the MDS scores and RUGs categories to the billing office within the required time frames.
17. Identifies cost variances and recommends cost recommends cost controls related to resource utilization.
18. Demonstrates ability to directly perform treatments and provide services to the level of licensure.
19. Knowledge of medication and their correct administration based on age of the patient and their clinical condition.
20. Consults other departments as appropriate to provide for an interdisciplinary approach to the patient’s care.
21. Demonstrates an ability to assist physicians with procedures and performs services requiring technical and manual skills.
22. Demonstrates an ability to be flexible, organized, and function under stressful situations.
23. Treats patients and their families with respect and dignity; ensures patient confidentiality and privacy.
24. Maintains a good working relationship both with all departments and with contacts from referring facilities and agencies.
25. Oversees patient care cost, acquisition and/or rental of medical equipment and supplies used with patients as ordered by the physician and noted in the plan of care.
26. Coordinates and supervises Medicare patient care activities as necessary to optimize resource utilization.
27. Attends meetings as required to include Medicare staff meetings, therapy meetings, and care plan meetings for skilled residents.
28. Coordinates care planning with Assessment Nursing for skilled residents.
29. Prepares requests for issuance of denial letters on admission and readmission.
30. Assists with discharging skilled residents.
31. Sees that supplies are available in proper quantities, that equipment is available in good condition and that personnel using such supplies and equipment know where such are to be found and know the proper care and use.
32. Assists with in-servicing to individualized needs.
33. Gives guidance to personnel as needed, evaluates performance, discusses progress and needs for improvement and prepares evaluations of performance as directed.
34. Assists the DON in other duties as directed.

PROFESSIONAL REQUIREMENTS:

1. Adheres to dress code, appearance is neat and clean.
2. Completes annual educational requirements per policy.
3. Maintains regulatory requirements.
4. Occasional travel/overnights required for training and professional meetings.
5. Reports to work on time and as scheduled. Completes work within designated time.
6. Wears identification while on duty.
7. Completes in-services and returns to work in timely manner.
8. Attends specified staff meetings, reads and returns all information required by immediate supervisor.

REGULATORY REQUIREMENTS:

1. Current State Nurse Licensure

LANGUAGE SKILLS:

1. Ability to read and communicate effectively in English.
2. Additional languages preferred.

SKILLS:

1. Current nursing assessment knowledge
2. Ability to develop plans of care
3. Ability to document patient care outcomes
4. Basic computer knowledge
5. Ability to organize and implement MDS and plan of care schedules

PHYSICAL REQUIREMENTS:

1. Ability to drive and possess a valid/current driver’s license.

PHYSICAL DEMANDS:

Use the percentages range as follows:

• 0% Never
• 1 - 33% Occasional
• 34 - 66% Frequent
• 67 - 100% Continuous

Requires full range of body motion including: