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1.877.891.4286
Home
About
Professional Licensure
Payroll & Documents
Apply Now
Open Jobs
Contact
Home
About
Professional Licensure
Payroll & Documents
Apply Now
Open Jobs
Contact
MDS Coordinator – Skills Checklist
This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Precision Nationwide Staffing.
0 = Not Applicable
1 = No Experience
2 = Some Experience
3 = Intermittent Experience
4 = Experienced
5 = Very Experienced
Age of Patient Cared For
Newborn/Neonate (birth - 30 days)
*
0
1
2
3
4
5
Infant (30 days - 1 year)
*
0
1
2
3
4
5
Toddler (1 - 3 years)
*
0
1
2
3
4
5
Preschooler (3 - 5 years)
*
0
1
2
3
4
5
School Age Child (5 - 12 years)
*
0
1
2
3
4
5
Adolescents (12 - 18 years)
*
0
1
2
3
4
5
Young Adults (18 - 39 years)
*
0
1
2
3
4
5
Middle Adults (39 - 64 years)
*
0
1
2
3
4
5
Older Adults (64 - 79 years)
*
0
1
2
3
4
5
Older Adults (over 79+ years)
*
0
1
2
3
4
5
Work Setting
Acute Care
*
0
1
2
3
4
5
Skilled/LTAC
*
0
1
2
3
4
5
Home Health
*
0
1
2
3
4
5
Workers Compensation
*
0
1
2
3
4
5
Insurance
*
0
1
2
3
4
5
Managed Care
*
0
1
2
3
4
5
Acute Rehab
*
0
1
2
3
4
5
Regulatory
CMS/Medicare
*
0
1
2
3
4
5
HEDIS Measures
*
0
1
2
3
4
5
Core Measures
*
0
1
2
3
4
5
Medicaid/Medical
*
0
1
2
3
4
5
DRG
*
0
1
2
3
4
5
ICD-10 Coding
*
0
1
2
3
4
5
CPT
*
0
1
2
3
4
5
RAPS
*
0
1
2
3
4
5
OBRA
*
0
1
2
3
4
5
MDS
*
0
1
2
3
4
5
Processes
Benefits Eligibility
*
0
1
2
3
4
5
Pre-Certification Review
*
0
1
2
3
4
5
Review for Admission Criteria
*
0
1
2
3
4
5
Identify Appropriate Level of Care
*
0
1
2
3
4
5
Develop Care Plans According to Patient Status
*
0
1
2
3
4
5
Review Status During Stay
*
0
1
2
3
4
5
Discharge Planning
*
0
1
2
3
4
5
Physician Advisor
*
0
1
2
3
4
5
Clinical Documentation Improvement
*
0
1
2
3
4
5
Needs Assessment/Order DME
*
0
1
2
3
4
5
Needs Assessment/Home Health
*
0
1
2
3
4
5
Needs Assessment/Hospice
*
0
1
2
3
4
5
Needs Assessment/Skilled
*
0
1
2
3
4
5
Concurrent Review
*
0
1
2
3
4
5
Retrospective Review
*
0
1
2
3
4
5
Professional Knowledge and Skills
National Patient Safety Goals
*
0
1
2
3
4
5
Age Specific Care
*
0
1
2
3
4
5
Population Based Care
*
0
1
2
3
4
5
Electronic Documentation
*
0
1
2
3
4
5
Electronic Documentation - List Types
*
Information & Agreement
Application ID
*
Please enter your application ID. This ID should be 15 characters long and have the format of PHNMS##########. You should have received an email containing your application ID when you submitted your initial application. If not, please contact our staff.
Applicant Name
*
First
Last
Applicant Email
*
Applicant Phone
*
I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified within the last 2 years.
*
I agree to the terms below.
The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Precision Nationwide Staffing. Submit this skills evaluation with your initial application. To be updated annually.
Signature
*