MDS Nurse (Registered Nurse)

Position Overview

This position is located at the Gallatin Rest Home and is responsible for coordinating and conducting periodic resident assessments and initiating and maintaining individualized care plans. The MDS Nurse ensures compliance with state and federal requirements for documentation, coding, and reporting under the Centers for Medicare & Medicaid Services (CMS) Patient Driven Payment Model (PDPM).

This position reports to the Rest Home Administrator and does not supervise other employees.

Each duty listed below makes up at least 20% of the job. All other functions are included in "Other Duties as Assigned." All listed duties are considered essential unless otherwise indicated.

Data Collection and Reporting

• Coordinate completion of the Minimum Data Set (MDS) for each nursing home resident assessment in accordance with CMS requirements.
• Review resident charts for nursing, therapy, physician, and interdisciplinary team (IDT) documentation and assessments; conduct resident and staff interviews to collect and verify required information.
• Determine the appropriate assessment type (e.g., 5-day, Interim Payment Assessment, or Discharge) based on resident history and CMS PDPM guidelines.
• Complete MDS assessment reports, incorporating all collected data, and interpret and apply instructions as outlined in the CMS MDS Manual.

Resident Care Plan Coordination

• Initiate, coordinate, and update resident care area narrative assessments and care plans to ensure compliance with timelines and regulations.
• Review charts and MDS data, conduct interviews, and develop preliminary care plans with problem statements, goals, and interventions; distribute to care team members for input and approval.
• Participate in Medicare Utilization Review meetings to assess current treatment plans, coordinate with administration and therapy staff, and recommend modifications as needed.
• Organize and coordinate care conferences, including notifying participants, reviewing electronic health records (EHR) for medication or care concerns, and documenting conference notes.

Scheduling, Records Management, and Training

• Review and process medical records for approved admissions; compile appropriate documentation for resident charts.
• Enter admission orders into the EHR and evaluate for completeness, contraindications, or irregularities, report findings for correction or follow-up.
• Review pre-admission medical records to determine appropriate ICD-10 codes for active diagnoses and ensure coding accuracy in MDS entries to optimize PDPM reimbursement.
• Assist with staff education related to MDS accuracy, documentation standards, and care planning best practices as directed.

Other Duties as Assigned

• Perform additional functions as assigned by the Rest Home Administrator. Duties may include special projects, assist other employees, and participate in ongoing training. In the event of a declared emergency (e.g., fire, flood, riot, or other disaster), County employees may be required to provide services during the emergency and subsequent recovery period.

Qualifications

Knowledge of:

• Human growth and development, nursing assessment, and long-term care best practices.
• Medical terminology, documentation standards, and the MDS assessment process.
• Medicare and Medicaid reimbursement systems, including PDPM and RUG methodologies.
• CMS and state regulations governing long-term care facilities.
• Care planning, interdisciplinary coordination, and resident-centered care approaches.

Skill in:

• Conducting accurate, detailed clinical assessments and interpreting complex medical data.
• Maintaining organized and compliant resident records and reports.
• Using electronic health record systems and related medical software.
• Communicating effectively with residents, staff, and medical professionals.
• Coordinating care and fostering collaboration within interdisciplinary teams.

Ability to:

• Work independently while maintaining compliance with established procedures.
• Prioritize tasks and manage multiple assessments simultaneously.
• Exercise sound clinical judgment and attention to detail.
• Communicate effectively, both verbally and in writing, with diverse audiences.
• Maintain confidentiality and demonstrate professionalism in all interactions.

Education & Experience

• Bachelor's degree in nursing from a National League of Nursing (NLN)-accredited program; and
• Current licensure as a Registered Nurse in the State of Montana; and
• Minimum of three (3) years of related clinical experience; or
• An equivalent combination of education and experience that provides the required knowledge and skills.
• Certification as a Resident Assessment Coordinator (RAC-CT) preferred.

Supplemental Information

As a condition of hire, pre-employment drug testing and background investigation may be done.

NOTE: Must be willing to work in a smoke free campus.

To be considered for this position please be prepared to attach the following required documents: Cover Letter, Resume, 3 Work References

Gallatin County is an equal opportunity employer. All applicants will be considered for employment on the basis of merit and qualifications without regard to race, creed, religion, color, or national origin or because of age, physical or mental disability, marital status, or sex when the reasonable demands of the position do not require an age, physical or mental disability, marital status, or sex distinction.

Health Benefits

• Individual health benefits premium is paid at 100% for full-time employees and pro-rated based on hours worked for part-time employees
• Includes limited vision and dental coverage (Dental is provided by MetLife and includes a dental buy-up option)
• Dependent health benefits premium is offered at very low costs
• Coverage is effective the 1st of the month following 30 days of employment
• Talkspace: In-Network behavioral health support through virtual counseling & psychiatry
• Optional Supplemental Coverage is offered through Mutual of Omaha including Voluntary Accident Policy, Voluntary Critical Illness Policy and Voluntary Life Insurance Policy (also available for dependents)
• FREE unlimited access and care to PMR Clinic East. This is a private Clinic and is available to all employees and family members who are enrolled in our health benefits.

Flexible Spending Accounts: Optional pre-tax, out-of-pocket medical expenses & day care expenses

County Paid Life Insurance: $50,000 Group Life Insurance Policy (eligible employees only) (age reductions apply)

County Paid Long Term Disability Insurance: Eligible employees only, benefit duration shortens once a specific age is reached

Retirement:

• County employees are covered by the Public Employee's Retirement System (PERS)
• County Deputies and Detention Officers are covered by the Sheriff's Retirement System (SRS)
• An optional supplemental 457 deferred compensation plan/ROTH is available through Empower and Nationwide

Paid Parental Leave:

• Eligible employees are offered a maximum of six weeks (240 hours) of paid parental leave for the bonding and care of a newborn child or adoption of a child

Sick and Vacation Leave:

• Employees accrue 12 sick days and 3 weeks of vacation per year, depending on years of service. (Hours are pro-rated for part-time employees)
• Leave starts accruing on an employee's date of hire and can be used as soon as time is in the books.

Holidays:

• The County observes 11 legal holidays in even numbered years (Federal Election Day) and 10 legal holidays in odd numbered years.
• A Floating Holiday is available to eligible employees after six months.

Health Club Memberships: Discounted rates are offered at participating clubs with payroll deduction.

Employee Assistance Program:

• Offer