Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.
| SETTING | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Acute Care |
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| Skilled/LTAC |
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| MDS Coordinator |
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| Home Health |
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| Telephonic |
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| Workers Compensation |
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| Insurance |
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| Managed Care |
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| Acute Rehab |
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| CM/UR SOFTWARE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Interqual |
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| Milliman |
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| MIDAS |
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| Allscripts UR |
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| Word Processing Software |
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| Other: Specify |
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| Other: Specify |
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| REGULATORY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| CMS/Medicare |
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| HEDIS Measures |
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| Core Measures |
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| Medicaid/Medical |
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| DRG |
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| ICD 9 Coding |
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| ICD 10 Coding |
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| CPT |
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| PROCESSES | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Benefits Eligibility |
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| Pre-Certification Review |
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| Review for Admission Criteria |
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| Identify Appropriate Level of Care |
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| Review Status During Stay |
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| Discharge Planning |
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| Physician Advisor |
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| Clinical Documentation Improvement |
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| Needs Assessment/Order DME |
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| Needs Assessment/Home Health |
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| Needs Assessment/Hospice |
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| Needs Assessment/Skilled |
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| Third Party Authorization Process |
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| Concurrent Review |
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| Retrospective Review |
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| PROFESSIONAL KNOWLEDGE AND SKILLS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| National Patient Safety Goals |
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| Age Specific/Population Based Care |
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| Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Infant (Birth - 1 year) |
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| Preschooler (ages 2-5 years) |
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| Childhood (ages 6-12 years) |
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| Adolescents (ages 13-21 years) |
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| Young Adults (ages 22-39 years) |
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| Adults (ages 40-64 years) |
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| Older Adults (ages 65-79 years) |
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| Elderly (ages 80+ years) |
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| EMR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Epic |
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| Cerner |
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| Eclipsys |
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| McKesson |
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| Meditech |
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| Allscripts |
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| Other: Specify |
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