Regional MDS Coordinator New York

Regional MDS Coordinator

Position Summary

The Regional MDS Coordinator is responsible for overseeing the accuracy, timeliness, and compliance of the Minimum Data Set (MDS) process across multiple facilities within the NY region (total of 8 facilities). This role ensures optimal clinical reimbursement under PDPM while maintaining regulatory compliance through auditing, education, and interdisciplinary collaboration. This position serves as a key leader in driving quality outcomes, audit readiness, and consistent MDS practices across the region.

Regional MDS Coordinator Required Qualifications

• Registered Nurse (RN) required

• RAC-CT or RAC-CTA certification preferred

• Minimum 3–5 years of MDS experience

• Prior multi-facility or regional experience preferred

• Strong knowledge of RAI Manual, PDPM, CMS regulations and audit processes

• Proficient in using laptops, mobile devices; well-versed in standard office software applications

• Must be a road warrior, willing to do regular in-person visits to facilities including unscheduled emergency situations

Regional MDS Coordinator Skills & Competencies

• Strong analytical and audit skills

• Excellent communication and teaching ability (adult learning principles)

• Leadership and ability to influence interdisciplinary teams

• High attention to detail and regulatory awareness

• Ability to translate complex regulations into practical workflows

Reporting Structure

• Reports to: Corporate Clinical Reimbursement - Compliance Officer

Collaborates regularly with Nursing Home Administrators (NHA), Directors of Nursing (DON), MDS Coordinators and Therapy and IDT leaders

Success Metrics

• Improved MDS accuracy and reduced error rates

• Increased CMI where appropriate

• Audit outcomes (reduced denials, improved defensibility)

• QRP compliance, contribute to VBP and NHQI improved quintiles

• Improved Quality Measures and Five-Star ratings

• Education completion and competency validation across facilities

Regional MDS Coordinator Key Responsibilities

1. MDS & PDPM Oversight

Oversee MDS completion, accuracy, and timeliness across assigned facilities

Ensure proper PDPM coding, including accurate capture of high audit MDS Items

Review Assessment Reference Date (ARD) management and scheduling practices

Monitor CMI trends and reimbursement opportunities through monthly meetings

2. Compliance & Audit Readiness

Conduct routine and focused MDS/compliance audits (internal and external readiness

Ensure documentation supports MDS coding and is defensible under audit

Monitor: Medicare Certifications, Physician documentation and orders, timely Interview completion (BIMS, PHQ-2 to 9, Pain, etc.)

Lead corrective action plans and QAPI initiatives related to audit findings

Prevent common audit risks (e.g., missing documentation, late assessments, unsupported coding, incomplete care plans)

3. Audit Support to Facilities

Provide support during both internal &external audits, including but not limited to: OMIG, RAC, MAC, and other regulatory reviews

Assist in document retrieval, validation, and organization

Review and preparation of audit response packets

Collaboration with facility leadership and corporate teams during audit processes

Participation in audit calls, exit conferences, and follow-up actions

4. Education & Training (Core Function)

Work with Corporate to deliver ongoing education to: MDS Coordinators, Nursing, Social Work, Therapy (PT/OT/SLP), Interdisciplinary Team (IDT)

Translate RAI Manual and CMS regulations into practical, role-specific guidance for SNFs

Lead In-services on various topics as directed by Corporate

Create or update educational tools as needed (guides, PowerPoints, workflows, audit

summaries)

5. Interdisciplinary Collaboration

Facilitate communication between Nursing, Therapy, Social Services, Dietary, and Physicians

Ensure IDT participation in: UR Meetings, Care planning, IDT Section GG determination, Triple Check Process, QAPI, Medical Meetings

Promote interdisciplinary accountability in documentation and care plan integration

6. Systems & Process Management

Monitor MDS workflows, submission timeliness, and error rates

Utilize data analytic tools such as SimpleLTC, PointRight and experience in EMRs such as PointClickCare & SigmaCare

Analyze data trends related to QM, Five-Star ratings, QRP, VBP and NHQI programs

Implement process improvements to enhance efficiency and accuracy

7. Quality & Reimbursement Optimization

Identify and accurate capture of PDPM drivers

Ensure alignment between clinical documentation and reimbursement outcomes

Support facilities in improving metrics including, but not limited to QM, VBP, QRP, NHQ