Job Specification Details

Specialized nursing work at a professional level involving the administration and oversight of the State Survey Agency Complaint Program. Oversight of the Complaint Unit Quality Plan to assure that federal and state mandates are met. Duties include screening and triage of reports of regulatory non-compliance, complaints against facilities, and reports of potential abuse to determine if an onsite or offsite investigation is warranted. Duties may also include onsite and offsite complaint investigations.

Screen and triage reports of alleged regulatory non-compliance to determine if complaint or facility based report is to be opened for investigation and to assign timeframe for onsite activity based on strict Centers for Medicaid and Medicare requirements.

Prepares reports and conducts quality reviews and maintains quality assessment and program improvement activities as required by the Centers for Medicare and Medicaid Services. Failure to meet federal requirements may result in sanctions to the state.

Reviews facility reports and information from other sources to identify health and safety areas of concern for concentration in surveys or complaint investigations. Makes appropriate referrals to other investigatory or regulatory agencies.

Conducts entrance conference with facility administrator and performs initial tour of facility.

On the basis of tour observations, interviews and pre-survey data, selects a sample of facility population for review.

Assesses overall environment and to include kitchen and food service sanitation.

Interviews residents and family members to ascertain their concerns regarding quality of life and quality of care provided.

Reviews medications for effectiveness, errors, and medical necessity.

Reviews facility quality assurance efforts, abuse prevention policies, and incident reporting procedures.

May assist with life safety inspections.

Reviews and analyzes findings and develops report detailing deficient practice and noncompliance with regulations based on state and federal regulatory requirements.

Recommends enforcement action as necessary which could include termination from the Centers for Medicaid and Medicare Services Program.

Conducts exit conference with facility administrator to discuss facility status and needed improvements.

Conducts investigations of any complaints received about care and treatment of residents.

Complete all mandatory state and federal training as required.

Performs other related duties as required.

Duties are performed in both field and office settings. Considerable travel to facility locations is required. Evening and weekend work is required. Overnight stays in a hotel are an expected requirement on a monthly basis. Resistance or objection to standards or to survey findings may be anticipated and requires considerable tact and diplomacy to achieve appropriate resolution. Survey deadlines, exit conferences, and interviewing may occasion considerable stress.

Expert knowledge of and competency in applying the principles and practices of professional nursing.

Working knowledge of other health care disciplines which are involved in total patient care.

Working knowledge of care needs of residents in a variety of health care settings.

Ability to interpret and apply rules and regulations of considerable complexity.

Ability to elicit sensitive information through interviews.

Ability to function independently with limited supervision. Ability to effectively communicate both verbally and in writing.

SMQT (Surveyor Minimum Qualification Test) Certification AND two (2) years or more as a Nurse Surveyor.

Possession of (or eligible for) licensure as a Registered Nurse (RN) in Vermont OR eligible to practice in the state of Vermont via a multi-state license.

NOTE: Must maintain Vermont or multi-state licensure as a Registered Nurse as a condition of employment.

Candidates must pass any level of background investigation applicable to the position. In accordance with applicable hiring standards, fingerprint supported criminal record checks, adult and child abuse registry checks, the Office of Inspector General exclusion database, and motor vehicle driving record checks, as appropriate to the positon under recruitment, will be conducted on candidates, with the exception of those who are current classified state employees seeking transfer, promotion, or demotion into a classified position or are persons exercising re-employment (RIF) rights.