MDS Coordinator

MDS Coordinator

Position Title: MDS Coordinator / Resident Assessment Coordinator

Department: Clinical / Nursing / Reimbursement

Reports To: Director of Nursing and/or Administrator May also receive support/direction from Corporate Clinical Reimbursement

Position Summary:

The MDS Coordinator is responsible for managing the Resident Assessment Instrument process, including timely and accurate completion of MDS assessments, care area assessments, care planning coordination, and Medicare/Medicaid reimbursement support. This position plays a key role in ensuring accurate resident assessment, regulatory compliance, quality measure performance, and appropriate reimbursement for services provided. The MDS Coordinator must be organized, clinically strong, detail-oriented, and able to work closely with nursing, therapy, social services, dietary, activities, medical records, billing, and facility leadership.

Essential Duties and Responsibilities

MDS / RAI Process:

• Coordinates and completes accurate MDS assessments in accordance with federal and state requirements.
• Ensures assessments are completed, signed, transmitted, and accepted timely.
• Maintains the MDS schedule, including OBRA, PPS, significant change, significant correction, quarterly, annual, admission, and discharge assessments.
• Monitors assessment reference dates, look-back periods, completion dates, and transmission deadlines.
• Reviews validation reports and corrects any rejected or inaccurate submissions promptly.
• Ensures Care Area Assessments are completed accurately and support resident needs and care planning.

Care Planning:

• Coordinates with the interdisciplinary team to ensure care plans reflect the resident’s current status, risks, needs, preferences, and goals.
• Ensures MDS findings are appropriately carried over into individualized resident care plans.
• Participates in care plan meetings as needed.
• Communicates changes in resident condition to appropriate team members to determine if a significant change assessment is required.

Medicare / Reimbursement:

• Supports accurate Medicare Part A documentation and reimbursement.
• Works with therapy, nursing, billing, and leadership to ensure skilled services are supported by documentation.
• Monitors PDPM clinical categories, nursing components, NTA items, and supporting documentation.
• Helps identify missing or incomplete documentation that may impact reimbursement or compliance.
• Participates in Medicare meetings and reimbursement reviews as assigned.

Quality Measures / Compliance:

• Monitors Quality Measures and assists the facility team in identifying trends and improvement opportunities.
• Supports survey readiness by ensuring MDS documentation is accurate, complete, and defensible.
• Assists with audits related to MDS accuracy, care plans, skilled documentation, diagnoses, and resident outcomes.
• Maintains knowledge of current CMS, RAI Manual, state, and facility requirements.
• Participates in QAPI activities related to clinical outcomes, reimbursement, documentation, and compliance.

Communication / Team Coordination:

• Serves as a resource to facility staff regarding MDS, documentation, skilled services, and care planning.
• Communicates clearly with nursing leadership regarding documentation needs, changes in condition, coding concerns, and compliance risks.
• Works collaboratively with therapy, social services, dietary, activities, billing, medical records, and providers.
• Provides education to staff as needed regarding documentation requirements and MDS-related processes.

Qualifications

Required:

• Current RN or LPN license in good standing.
• Long-term care or skilled nursing facility experience.
• Strong understanding of resident assessment, care planning, and clinical documentation.
• Ability to manage deadlines, prioritize work, and maintain accuracy.
• Strong communication and organizational skills.
• Knowledge of Medicare, Medicaid, OBRA, PPS, PDPM, and RAI requirements preferred.

Preferred:

• Prior MDS Coordinator experience.
• RAC-CT certification or willingness to obtain.
• Experience with PointClickCare, our electronic medical record system.
• Knowledge of Quality Measures, Five-Star, survey process, and skilled documentation requirements.

Core Competencies

• Accuracy and attention to detail.
• Strong clinical judgment.
• Regulatory compliance mindset.
• Ability to hold staff accountable for documentation.
• Strong follow-through.
• Team-focused communication.
• Ability to work independently without constant prompting.
• Calm under pressure and able to manage multiple deadlines.

Physical and Work Environment Requirements

• Works primarily in a skilled nursing facility environment.
• Must be able to sit, stand, walk, bend, and move throughout the facility as needed.
• Must be able to use a computer for extended periods.
• Must be able to communicate effectively with residents, families, staff, providers, and leadership.
• May require occasional lifting or assisting in resident care in accordance with licensure and facility needs.

Performance Expectations

The MDS Coordinator is expected to:

• Keep all MDS assessments timely and accurate.
• Maintain a clean and reliable MDS schedule.
• Support appropriate reimbursement through accurate coding and documentation.
• Identify significant changes timely.
• Ensure care plans are individualized and match the resident’s assessed needs.
• Support Quality Measure improvement.
• Maintain survey-ready documentation.
• Communicate concerns early, clearly, and professionally.
• Work as part of the facility leadership team, not in a silo.

Disclaimer

This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the position. Duties may be added, changed, or reassigned based on facility needs, regulatory requirements, and leadership direction.