Gracebel Reyes

I am a Registered Nurse that is currently practicing as Remote Quality Assurance in Skilled Nursing Facilities.

Here's the scope of the tasks I do:

• Review and analyze concurrent progress notes, consultant reports, and medication records of patients for completeness, compliance, and documentation accuracy in the live EHR platform.

• Review of documentation in compliance with Federal and State Regulations.

• Review and monitor Risk Management/ Events for complete and defensive documentation.

• Identify and address documentation discrepancies.

• Help SNFs identify specific ICD diagnoses and comorbidities that affect the payment under the PDPM.

• Review of compliant documentation that described and supports the ICD diagnosis for Medicare Claims / HIPPS code (s) billed to protect the facility from Recovery Audit Contractors (RAC).

• Monitor the skilled documentation.

• Review of Active and resolved ICD Diagnosis.

• Help facilities maintain positive scores with grading agencies and government entities that evaluate hospitals for the public.

• Evaluate core measures, hospital-acquired conditions (infection), patient safety indicators, quality indicators that require improvements through documentation review.

• Review of MDS Assessment creation and submission timeline.

• Review the types of Assessments (Facility Required)

• Review and identify MDS PBJ discrepancies.

• Review of SNF QRP Triggered Quality Measures.

• Data Entry, navigation, and creation of documentation in the EHR (Point Click Care).

• Facilitate one on one meetings with the clinical team to enhance the quality and compliance of documentation.

• Train and supervise newly hire Nurse auditors in our Team.

• Coordinate and follow up with Medical Record Staff and Director of Nursing audit findings that entered in Microsoft Excel Forms thru Outlook and Call for urgent matters.

I can work independently, keen on details. I am also willing to be trained and open to an opportunity in learning new skills.