Director, Post Acute Assessments

1 week ago

Boston, Massachusetts, United States Spaulding Rehabilitation Hospital Full time
Job Summary

The Director of Post Acute Assessments is responsible for overseeing the accurate and timely completion of post-acute prospective payment and mandatory assessment instruments. This includes:

  • Inpatient Rehabilitation Facility (IRF) - IRF Patient Assessment Instrument (IRF-PAI)
  • Skilled Nursing Facility (SNF) - Minimum Data Set (MDS)
  • Long Term Care Hospital (LTCH) - Continuity Assessment Record and Evaluation (CARE tool)

The Director of Post Acute Assessments supports, trains, and collaborates with the IRF PAI, MDS, and CARE tool staff and the Interdisciplinary Care Team to ensure regulatory compliance and assessment integrity. Under the direction of the Chief Compliance Officer, the Director facilitates improvement in the overall quality, completeness, and accuracy of CMS assessments to drive accurate quality reporting program information and revenue integrity.

Key Responsibilities

The Director of Post Acute Assessments is responsible for:

  • Managing CMS assessment operations, competencies, and regulatory compliance
  • Hiring, training, supporting, and guiding IRF PAI, MDS, and CARE tool staff to ensure timely completion and transmission of CMS assessments
  • Coordinating annual review of and response to proposed and final CMS rules
  • Ensuring a systematized workflow to ensure assessments are completed per required timeframes prescribed by CMS regulations
  • Collaborating with assessment and clinical staff to ensure timely patient assessment data collection for quality measure calculation and payment determination
  • Applying diplomacy and professionalism when interacting with physicians and clinical staff, especially when addressing missing or conflicting medical record information
  • Staying abreast of IRF-PAI, MDS, and Care Tool Manual content and facilitating communication of and amend workflows related to changes
  • Monitoring compliance with data collection and submission deadlines for the IRF, SNF, and LTCH Quality Reporting Program (QRP)
  • Monitoring, managing, and/or developing work queues to assist in the completion and timely submission of data collection
  • Implementing internal controls to assure accuracy; gathering, formatting, and reporting data to Compliance Officer monthly
  • Participating in quality improvement initiatives related to IRF PAI, MDS, and CARE tool data
  • Coordinating coverage with the assessment team to ensure timely completion of assessments
  • Responsible for gathering, analyzing, and trending statistical data; sharing with leadership and clinical teams to celebrate successes and identify opportunities for improvement
  • Reviews external (i.e., PEPPER) and internal data (i.e., outliers) to trend, track and educate to improve outcomes
  • Assists with preparing and presenting clinical documentation monitoring/trending reports for review with physicians and hospital leadership
  • Is a liaison between the Assessment/Outcomes team and eCcare support
  • Manages relationships with CMS assessment IS vendors (UDS, LTRAX)
  • Exhibits skillful, up-to-date working knowledge of post-acute coding guidelines (Federal and State, etc...), researching websites, publications, reference materials, and educational opportunities. Collaborates with the Coding Manager to understand and adhere to coding policies and guidelines published in the "Coding Clinic" and coding department policies and procedures
  • Keeps current with CMS assessment regulatory changes, proposed and otherwise, through conferences, reference material, and review of current literature
  • Maintains confidentiality of all customer/hospital information
  • Demonstrates flexibility in changing work environment, adjusting work schedule accordingly
  • Upholds the Organizational Values of Innovation, Collaboration, Accountability, Respect, and Excellence

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