Nurse Assessment Coordinator (NAC) Previously known as MDS Coordinator

The Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual, version 1.16, describes the current federal requirements for assessments in the long-term care setting (p. 2-1):

The statutory authority for the RAI is found in Section 1819(f)(6)(A-B) for Medicare, and 1919 (f) (6)(A-B) for Medicaid, of the Social Security Act (SSA), as amended by the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987)…

The OBRA regulations require nursing homes that are Medicare certified, Medicaid certified or both, to conduct initial and periodic assessments for all their residents. The Resident

Assessment Instrument (RAI) process is the basis for the accurate assessment of each resident. The MDS 3.0 is part of that assessment process and is required by CMS…

MDS assessments are also required for Medicare payment (Prospective Payment System [PPS]) purposes under Medicare Part A… or for the SNF QRP required under the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act).

The complexity of these requirements is paramount to the success of the financial operations in our facilities and the care of our residents. The nurse assessment coordinator (NAC) is largely responsible for ensuring compliance with these federal requirements.

Job Summary:

As defined in Appendix A of the RAI User’s Manual, the nurse assessment coordinator (NAC) is “an individual licensed as a registered nurse by the State Board of Nursing and employed by a nursing facility, and is responsible for coordinating and certifying completion of the resident assessment instrument.”

The NAC is ultimately responsible for adequately assessing nursing facility residents’ needs using the federally mandated Resident Assessment Instrument (RAI) process and for coordinating individualized resident-centered care.

The NAC works with the interdisciplinary team (nursing, therapy, dietary, social services, activities, etc.) to develop, revise, update, and maintain a comprehensive care plan and ensure that compliance is maintained with state and federal guidelines.

The NAC is responsible for attesting to the completion of the Minimum Data Set (MDS), which is the key driver for Medicare payment and many Medicaid reimbursement systems.

The NAC serves as the expert resource for the Patient-Driven Payment Model (PDPM) and is responsible for complying with ethical standards when setting ARDs, completing assessments, and upholding Medicare requirements.

Finally, the NAC assists with the coordination of care delivery by applying advanced nursing clinical skills, completing assessments, analyzing data, educating team members, and coordinating the exchange of resident information across the care settings.

Essential functions

The essential functions listed below are typical examples of work performed by staff members in this job classification.

This list is only partial and should not be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities.

• Coordinate the RAI process, which includes, at a minimum, the following elements:

• Minimum Data Set (MDS)

• Care Area Assessment process

• Care plan development

• Care plan implementation

• Evaluation

• Provide oversight of assessment completion and transmission to the national repository.

• Review final validation reports and corrections or modifications in response to warnings or errors

needed

• Oversee the baseline care plan and coordinate the completion of the comprehensive care plan

according to regulatory requirements

• Maintain the MDS OBRA and PPS assessment schedules

• Be highly involved in determining skilled level of care for Medicare residents and procuring

required Medicare-specific documentation; be responsible for physician certification of a skilled

level of care throughout the Medicare stay; be involved in making eligibility determinations

• Coordinate care with Social Services for residents utilizing managed care, health maintenance

organizations (HMOs), commercial insurance, and other alternate payment models

• Maintain compliance with state-specific regulations regarding the RAI process

• Provide insight and analysis of MDS-based Quality Measures

• Serve as a member of the quality assessment and assurance (QAA) and/or the quality assurance

and performance improvement (QAPI) committees

• Work closely with hospital discharge planners and physicians to obtain accurate and complete

documentation to support ICD-10-CM diagnosis coding and surgical procedures

• Audit and improve staff education/competency as needed to ensure accurate and timely

completion of supporting documentation and MDS assessments

• Participate in discharge planning, training, caregiver training, and the provision of resources as

needed

• Foster effective working relationships and build consensus

• Maintain confidentiality of sensitive information

• Plan, organize, prioritize, work independently, and meet deadlines

• Use judgment and make sound independent decisions

• Work effectively with individuals at all levels of the organization, as well as with residents,

family members, visitors, government personnel, and the public

• Speak, read, write, and understand English effectively at a level appropriate for the safe and

effective performance of the job

• Be knowledgeable of regulations, practice standards, and procedures, as well as laws, regulations,

and guidelines pertaining to the RAI process

• Possess the ability to plan, organize, develop, implement, and interpret the programs, goals,

objectives, policies and procedures, etc., that are necessary for ensuring the accurate and timely

completion of the RAI documents

• Have the ability to learn computer systems, system applications, and related office equipment

• Ensure that the residents’ rights to fair and equitable treatment, self-determination, individuality,

privacy, property, and civil rights, including the right to wage complaints, are always well-

established and maintained

• Review resident complaints and grievances associated with the RAI process and care delivery

protocols; make written reports of action taken; discuss with the resident, representative, and

family as appropriate.

Knowledge, skills, and abilities

These are the observable and measurable attributes and skills required to successfully perform the essential functions of the job; they are generally demonstrated through qualifying experience, education, or licensure/certification.

• Must be a registered nurse (RN)

• Licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) may be hired in a

secondary NAC positions with RN oversight

• MDS experience or certification is preferred

• At a minimum, must have knowledge of current state and federal regulations, particularly the

following pertinent sections of Appendix PP:

• 483.20 Resident Assessments

• 483.21 Comprehensive Resident-Centered Care Plans

• Desired traits: integrity, attention to detail, accuracy, time-management skills, ability to meet

deadlines, critical-thinking skills, written and verbal communication skills, care plan

development skills, and problem-solving skills

Physical requirements and working conditions

• Work in well-lighted/ventilated office areas, as well as throughout the nursing service areas

• Sitting, standing, bending, lifting, and moving intermittently during working hours

• Subject to frequent interruptions

• May be required to lift residents, medical equipment, and supplies

• Is subject to exposure to infectious waste, diseases, and conditions

• Be economical and careful with supplies and equipment

• Must possess sight/hearing senses or use prosthetics that enable these senses to function

adequately so that the requirements of this position can be fully met

• Reasonable accommodations will be made to enable individuals with disabilities to perform the

essential functions of the job