Primary Responsibilities

The Regional Clinical Specialist will serve as an adviser, trainer, educator and auditor and will assist and support the facility Administrator, Director of Nursing, Medicare Coordinator and Assessment Nurses. The Regional Clinical Specialist is responsible for reviewing the operational systems of the facility, the maintenance of records and personnel to promote adequate level of care to facility residents.

The Regional Clinical Specialist will review Medicare and Medicaid claims for appropriate reimbursement. The Regional Clinical Specialist is there to assist with the hiring of managers in an advisory capacity only.

Essential Functions

Must meet with the Administrator upon entrance to the facility to communicate the purpose of each visit. Communicate with the Administrator and Director of Nursing, Medicare Coordinator and/or Assessment Nurse any pertinent findings of their visit throughout the day. Must meet with the Administrator, Director of Nursing or designee upon exiting of the facility to communicate any relevant findings and development of any Plan of Corrections. Must start and assist the facility with the Plan of Correction to address any insufficient practices that were noted during their visit to the facility. The Plan of Correction must include observation(s), record review(s) and interview(s). Communicate with the Administrator and the Director of Nursing after each visit to follow-up on any agreed Plan of Corrections. Must submit a written report to the QA Consultants, Director of Nursing, Administrator and any relevant facility staff. Review other consultant reports to promote consistency in the application of rules and regulations. Promote communication within the facility in an interdisciplinary manner. Review any and all regulatory reports (i.e. 2567, Quality Monitoring reports, Quality Indicators, etc.) and evaluate compliance with TDADS regulations Actively participate in corporate quality assurance. Attend quarterly Policy/Forms/QA Committee meeting and actively participate in the development of facility policies and procedures. Recommend policy and procedure changes and/or updates. Review policies and procedures adopted by the facility to promote regulatory compliance. Review facility reports (i.e. facility QA reports and Simple CFS reports, etc.) Review resident clinical records. Review Reimbursement Binders and associated documentation to promote regulatory compliance. Provide training to the Medicare Coordinator, Assessment Nurse and pertinent facility staff. Research other training methods, materials and resources May be necessary to assist in the evacuation of residents during emergency situations. Actively assist and participate in the enhancement of the lives of our residents through; our dedicated approach to patient care and our census-building program. Actively assist and participate in the development and retention of staff through; recruitment, training and nurturing the employees of the nursing home.