The PPS Coordinator provides timely and accurate data completion, including quality measures of the Medicare reporting instrument (the Inpatient Rehabilitation Facility- Patient Assessment Instrument (IRF-PAI)) for each rehabilitation inpatient. This leader provides data for and attends patient Team Conferences; participates in meetings and committees as directed. This individual assures accuracy in the scoring of functional status and reflection of the patient's care needs, as documented in the electronic medical record and the UDS Pro-Doc system, in collaboration with the interdisciplinary team. In addition this position is responsible for educating and supporting the licensed clinical staff on the Functional Independence Measure (FIM Training). This position assists in ongoing performance improvement of hospital goals, and achieving identified outcome benchmarks for the inpatient population. The PPS Coordinator participates in the hospital wide quality auditing and monitoring program.
Responsible for staff orientation and ongoing education to improve FIM score accuracy at admission, throughout the stay and upon discharge. Serves as educator of Functional Independence Measure (FIM) scoring according to Uniform Data System (UDS) training materials
Serves as a resource to licensed clinicians and clinical staff regarding questions and interpretation of FIM scoring guidelines, according to UDS training guidelines, in order to assure the accuracy of the FIM scores.
Provides ongoing education to the staff of the hospital to assure accurate and timely completion of the IRF-PAI.
Responsible for staff orientation and ongoing education and facilitate biannual UDS MR staff credentialing for FIM scoring.
Review medical record documentation using the UDS Pro-Doc System, to support the accuracy and timeliness of the functional scores and comorbid conditions, according to CMS guidelines.
Assures that the IRF- PAI is consistent with the medical record documentation and reflects the functional status and 24-hour care needs of the patient.
Collaborates with physicians and interdisciplinary team members to make the most accurate assessment of the needs and strengths of patients are captured in the UDS-Pro Doc system, i.e., in the medical record.
Review current facility clinical documentation in the hard chart and UDS Pro Doc and evaluate accuracy through the use of SMART FIM.
Compares actual knowledge of the patient to care provided to the patient and the information contained on the IRF- PAI. Makes appropriate corrections to the IRF PAI in collaboration with the interdisciplinary team in order to accurately reflect the burden of care upon admission, throughout the stay and upon discharge.
Investigates the IGC and co-morbidities in a collaborative manner with the physicians and coders that would allow for accurate coding of the patient's stay.
Oversees/completes and analyzes any FIM data assuring the accuracy and the completion of the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) according to CMS guidelines and prior to electronic transmission.
Reviews the medical record documentation to ensure accuracy and to support the correct Case Mix Group (CMG) assignments.
identifies target reference dates for the completion of the IRF-PAI for all patients
Coordinates the completion of the admission assessment of the IRF-PAI by the fourth (4 th ) day of the patient's stays and the third (3rd) day following discharge for each inpatient rehabilitation patient. May require discussions/interactions with various staff members concerning differences in reported and/or medical record documentation of functional status to complete the PAI. Uploads FIM scores in UDS Pro Doc necessary to complete the IRF PAI.
Coordinates with Health Information (Medical Records) prior to Submitting completed IRF PAI by HIM Department to CMS National Database.
PPS Coordinator and the HIMs department (coder) work collaboratively to assure timely completion and transmittal of the IRF PAI.
Maintains current knowledge of the UDS Pro-Doc system and CMS IRF-PAI software and provides expertise on this software within the inpatient rehab setting and contributes to facility process improvement plans.
Maintains updated and ongoing knowledge of the regulations concerning the IRF-PAI and its completion within the inpatient rehab setting.
Has working knowledge of capabilities of UDS Pro-Doc, including various reports and how to access and use.
Has working knowledge of UDS Pro-Central, including various reports and how to access, interpret and use.
Serves as an information source and educator to IRF-PAI users.
Periodically performs medical record audits including audits of the IRF PAI instrument, clinical documentation and billing information to assure accuracy and consistency of documentation.
Demonstrates effective critical thinking skills.
Provides an environment conducive to safety for patients, visitors and staff.
Utilizes appropriate leadership skills in delegating, organizing and educating coworkers and staff.
Promotes participation, cooperation and teamwork. Demonstrates problem solving in resolving issues. Demonstrates clear and effective communication skills.
The PPS Coordinator has access to confidential patient information and maintains confidentiality of all information.
Will consider RN, or Licensed/Registered PT, PTA, OT, OTA or SLP.
Current Basic Life Support/CPR card.
Certified/credentialed in UDS MR FIM, preferred.
Has attended or is eligible to attend the UDS boot camp.
Three (3) to five (5) years of experience in the care of patients in an acute hospital or rehabilitation setting preferred.