Responsible for the comprehensive assessment process for each resident including coordination with interdisciplinary team to assure timely plan of care documentation in compliance with state regulations. Is responsible for achieving compliance with state and federal regulations relating to the MDS process. Directs and evaluates the nursing care of patients/residents according to hospital policies and procedures and accepted principles of practice including nursing assessment, nursing diagnosis, patient education, appropriate documentation, and discharge planning. Initiates Minimum Data Set Assessment including Triggers, Resident Assessment Protocols and formulation of Resident Care Plan upon admission and at required intervals thereafter. Reviews residents' medical records to gather and verify information. Confers with charge nurses who do ongoing assessments of residents, observe for changes in resident's condition and response to treatment and reports pertinent information to the LTC Director of Nurses and/or physician. Coordinates multi-disciplinary team in the timely completion of the MDS and the development and periodic revision of written Resident Care Plans which reflect each resident's specific and age related needs and concerns. Guides the interdisciplinary team in design and implementation of Resident Care Plans. Guides the interdisciplinary team with revisions and additions to Resident Care Plans and the MDS annual and periodic assessments. Through ongoing assessment, evaluates resident outcomes and response to care plan. Participates in quality management activities by coordinating LTCU monitoring and data gathering and reporting activities.