MDS COORDINATOR
POSITION DESCRIPTION

LOCATION:       Bon Secours Maria Manor
DEPARTMENT:   Nursing
FLSA STATUS:   Non-exempt
REPORTS TO:    Unit Manager
SUPERVISES:    None

MINIMUM QUALIFICATIONS:
Education: Must possess, as a minimum, a Nursing Degree from an accredited college or university.
Licensure: State of Florida Registered or Licensed Practical Nurse
Experience: Must have, as a minimum, 2 years experience in rehabilitative and restorative nursing practices.

SPECIFIC REQUIREMENTS: Must possess a current, unencumbered, active license to practice as a Registered Nurse in this state or been enrolled for at least 6 months in an RN program. Must be able to read, write, speak, and understand the English language. Must possess the ability to make independent decisions when circumstances warrant such action. Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel, and the general public. Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care. Must possess leadership and supervisory ability and the willingness to work harmoniously with professional and non-professional personnel. Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies and procedures, etc., that are necessary for providing quality care. Must have patience, tact, a cheerful disposition and enthusiasm, as well as the willingness to handle difficult residents. Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices. Must be able to relate information concerning a resident's condition. Must not pose a direct threat to the health or safety of other individuals in the workplace.

PURPOSE OF YOUR JOB POSITION: The primary purpose of your job position is to conduct and coordinate and complete MDS/PPS care plans for resident assessment in accordance with the requirements of this state and the policies and goals of this facility.

DELEGATION OF AUTHORITY: As the Clinial Data Coordinator you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties. Your immediate supervisor is the Director of Nursing Services.

JOB FUNCTIONS: Every effort has been made to make your job description as complete as possible. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is a logical assignment to the position.

WORKING CONDITIONS: Works in office area(s) as well as throughout the nursing service area (i.e., drug rooms, nurses' stations, resident rooms, etc.). Sits, stands, bends, lifts and moves intermittently during working hours. Is subject to frequent interruptions. Is involved with residents, personnel, visitors, government agencies/personnel, etc., under all conditions and circumstances. Is subject to hostile and emotionally upset residents, family members, personnel, and visitors. Communicates with the medical staff, nursing personnel, and other department supervisors. Works beyond normal working hours and on weekends and holidays when necessary. Is involved in community/civic health matters/projects as appropriate. Attends and participates in continuing educational programs. Is subject to falls, burns from equipment, odors, etc., throughout the work day. Is subject to exposure to infectious waste, diseases, conditions, etc., including TB and the AIDS and Hepatitis B viruses. Maintains a liaison with the residents, their families, support departments, etc., to adequately plan for the residents' needs.

PHYSICAL AND SENSORY REQUIREMENTS (With or Without the Aid of Mechanical Devices): Must be able to move intermittently throughout the workday. Must be able to speak and write the English language in an understandable manner. Must be able to cope with the mental and emotional stress of the position. Must be able to see and hear or use prosthetics that will enable these senses to function adequately to ensure that the requirements of this position can be fully met. Must function independently, and have flexibility, personal integrity, and the ability to work effectively with residents, personnel, and support agencies. Must be in good general health and demonstrate emotional stability. Must be able to relate to and work with the ill, disabled, elderly, emotionally upset, and at times hostile people within the facility. Must be able to lift, push, pull, and move a minimum of 15 pounds. Must be able to assist in the evacuation of residents during emergency situations.

RESIDENT RIGHTS: Maintain the confidentiality of all resident care information. Ensure that all residents are treated fairly, and with kindness, dignity, and respect. Ensure that resident interviews are conducted in private. Ensure that all members of the assessment team and the interdisciplinary care planning/medical and nursing team are knowledgeable of the residents' responsibilities and rights including the right to refuse treatment. Ensure that nursing staff personnel honor the resident's refusal of treatment request. Ensure that such requests are in accordance with the facility's policies governing advance directives. Ensure that the facility's policies and procedures governing advance directives are reviewed with the resident and/or representative. Report and investigate all allegations of resident abuse and/or misappropriation of resident property. Review any complaints or grievances made by residents regarding the resident assessment or care plan. Ensure that a written record is made of any resident's complaints or grievances with a full accounting of any actions taken and the current status of the complaint.

BON SECOURS MISSION & VALUES
a.) Consistently demonstrates full understanding of the mission and values of Bon Secours.
b) Treats residents, visitors and staff members in dignified manner with respect, kindness and understanding.
c) Is pleasant and professional at all times with all interactions.
d) Attends mandatory Mission inservices.
e) Uses time productively coordinating with others to achieve common goals and objectives.

CARE PLAN AND ASSESSMENT
a) Develop preliminary and comprehensive assessments of the nursing needs of each resident, utilizing the forms required by current rules or regulations and facility policies.
b) Ensure that appropriate health professionals are involved in the assessment.
c) Ensure that all members of the assessment team are aware of the importance of completeness and accuracy in their assessment functions and that they are aware of the penalties, including civil money penalties, for false certification.
d) Coordinate the development of a written plan of care (preliminary and comprehensive) for each resident that identifies the problems/needs of the resident, indicates the care to be given, goals to be accomplished, and which professional service is responsible for each element of care.
e) Ensure that the care plan includes measurable objectives and timetables to meet the resident's medical, nursing, and mental and psychosocial needs as identified in the resident's assessment.
f) Ensure that an initial resident assessment is completed within fourteen days of the resident's admission. g) Ensure that a comprehensive care plan is completed within twenty-one days of the resident's admission.
h) Assist the nursing staff in encouraging the resident and his/her family to participate in the development and review of the resident's plan of care.
i) Develop the schedule of activities required for the resident assessment and plan of care.
j) Assist the Director of Nursing Services and relevant supervisors of other departments in ensuring that all personnel involved in providing care to the resident are aware of the resident's care plan and that nursing personnel refer to the resident's care plan prior to administering daily care to the resident.
k) Ensure that quarterly and annual resident assessments and care plan reviews are made on a timely basis.
l) Ensure that a complete resident assessment is conducted within fourteen days of a significant change in the resident's condition.
m) Coordinate the review and revision of the resident's care plan by the interdisciplinary team after each quarterly eview or other assessment, assuring that the care plan is evaluated and revised each time an assessment is done or when there is a change in the resident's status.
n) Assist the Director of Nursing Services and other relevant directors and supervisors in maintaining good rapport and morale between and within departments to ensure that a team effort is achieved in developing and implementing a comprehensive assessment and plan of care.
o) Inform all assessment team members of the requirements for accuracy and completion of the resident assessment (MDS).
p) Ensure that each portion of the assessment is signed and dated by the person completing that portion of the MDS. q) Sign and date the assessment instrument to certify its completion.
r) Ensure that medical and nursing care is administered in accordance with the resident's wishes, including the implementation of advance directives.

ADMINISTRATIVE FUNCTIONS
a) Conduct and coordinate the development and completion of the resident assessment (MDS) in accordance with current rules, regulations, and guidelines that govern the resident assessment, including the implementation of RAPs and Triggers.
b) Maintain and periodically update written policies and procedures that govern the development, use, and implementation of the resident assessment (MDS) and care plan.
c) Perform administrative duties such as completing medical forms, reports, evaluations, studies, etc.,as necessary.
d) Develop, implement, and maintain an ongoing quality assurance program for the residents assessment/care plans.
e) Assist the resident and Discharge Planning Coordinator in completing the care plan portion of the resident's discharge plan.
f) Participate in surveys (inspections) made by authorized government agencies.
g) Act as Charge Nurse if needed.

NURSE CARE FUNCTIONS
a) Conduct or coordinate the interviewing of each resident for the resident's assessment.
b) Evaluate each resident's condition and pertinent medical data to determine any need for special assessment activities or a need to amend the admission assessment.
c) Develop and implement procedures with the Director of Nursing Services to inform all assessment team members of the arrival of newly admitted residents.
d) Assist facility directors and supervisors in scheduling the resident assessment/care plan meetings.
e) Contact and assist in scheduling participation by outside members of the care plan team, including the resident's representative and/or other interested family members.
f) Ensure that care provided is in accordance with the resident's wishes.

STAFF DEVELOPMENT
a) Develop and participate in the planning, conducting, and scheduling of timely in-service training classes that include assessment skills or techniques needed to complete the assessment functions of the facility.
b) Assist the In-service Training Coordinator in developing any training activities needed concerning resident assessment/care plan skills (including, but not limited to initial or refresher courses relative to techniques for interviewing residents, rehabilitation principles, commonly used psychotropic drugs, care plan functions, etc.).
c) Attend and participate in annual mandated OSHA and CDC in-service training programs for hazard communication, TB management, and blood borne pathogens standard.
d) Attend and participate in advance directive in-service training programs for the staff and community.
e) Attend and participate in continuing education programs designed to help you keep abreast of changes in your profession, as well as to maintain your license on a current status.

PERSONNEL FUNCTIONS
a) Maintain an effective, friendly working relationship with health professionals, physicians, consultants, and governmental agencies that may be involved in the resident assessment/care plan functions of the facility.
b) Meet with and solicit advice from department supervisors concerning the resident assessment/care plan functions of the facility.

COMMITTEE
a) Work with the Interdisciplinary Care Plan Team in developing a comprehensive resident assessment and care plan for each resident.
b) Serve on, participate in, and attend various other committees of the facility (e.g. Policy Advisory, Quality Assessment and Assurance) as required and as appointed by the Administrator/DON.
c) Provide written and/or oral reports of the resident assessment/care plan functions as requested or directed by such other committees.
d) Participate in functions involving discharge plans as may be necessary.
e) Attend and participate in the Utilization Review Committee functions as required or as may be necessary.
f) Evaluate and implement recommendations from established committees as they may pertain to the assessment and/or care plan functions of the facility.