REMOTE POSITION - TX OR COMPACT LICENSE REQUIRED REQUIRED: ICD-10 Coding Certification (HCS-D or equivalent) OASIS Certification (COS-C or equivalent) Adaptive Home Health is building a higher-acuity, patient-centered home health model across Texas. Our QA RN role is critical to that mission: you ensure clinical accuracy, regulatory compliance, and optimal reimbursement while supporting field clinicians with actionable feedback and continuous quality improvement. Who We Are: We build technology to better support our clinical operations and compliance teams. Our documentation and QA workflows are designed to streamline OASIS review, reduce rework, and maintain defensible, high-quality submissions. If you have sharp clinical judgment, deep OASIS expertise, and you thrive in a remote, productivity-based environment, this role offers meaningful impact on patient outcomes and agency performance. What you will do: Review and validate all assigned OASIS assessments (SOC, ROC, Recert, Transfer, Discharge) for accuracy, completeness, and internal consistency Code and sequence diagnoses per ICD-10 and CMS guidelines to ensure optimal reimbursement and quality measure alignment Identify and correct errors impacting reimbursement, quality measures, or compliance before submission Provide clear, actionable feedback to field clinicians when revisions are required, with a focus on education and process improvement Ensure all OASIS submissions meet current CMS, Medicare, and payer requirements Stay current on OASIS updates, CMS guidance, and regulatory changes; communicate relevant updates to clinical leadership Support agency compliance with Conditions of Participation (CoPs) and internal quality standards Identify recurring documentation trends or risk areas and contribute recommendations for clinician training and workflow optimization Collaborate with clinical leadership to improve outcomes, reduce audit risk, and maintain defensibility Complete assigned OASIS reviews within defined turnaround times while maintaining high accuracy standards Communicate promptly and professionally with clinicians and leadership regarding discrepancies, missing documentation, or process improvements Why Adaptive Clear, performance-based comp: $35 per locked OASIS review—earn based on quality and productivity Remote flexibility: Work from home with flexible hours designed to scale with agency census Mission-driven impact: Directly influence patient care quality, clinician development, and agency compliance Strong operational support: Collaborate with experienced clinical and compliance leadership Tech-forward environment: Leverage tools designed to streamline QA workflows and reduce administrative burden Requirements Must-haves Active, unrestricted Texas or Compact RN license Minimum 2 years of home health experience ICD-10 Coding Certification (HCS-D or equivalent) OASIS Certification (COS-C or equivalent) Strong understanding of Medicare home health reimbursement and PDGM High attention to detail and strong clinical judgment Ability to work independently in a remote environment with minimal supervision Excellent written and verbal communication skills Proficiency with EMR systems (HCHB preferred) and Microsoft Office Nice-to-haves Prior experience in home health QA, auditing, or coding Familiarity with Homecare Homebase (HCHB) or AXXESS Experience working in a per-review or productivity-based role Background in OASIS education or clinician training Performance Expectations Accurate and compliant OASIS reviews with minimal rework Consistent turnaround times aligned with agency workflow needs Clear, professional, and constructive communication with clinicians and leadership Ongoing adherence to quality and compliance standards Proactive identification of trends and process improvement opportunities Physical & Technical Requirements Ability to work at a computer for extended periods Reliable high-speed internet access and secure, HIPAA-compliant workspace Proficiency with EMR systems, Microsoft Office, and virtual communication tools (Slack, Zoom, etc.) Equal Opportunity We are an equal opportunity employer and value diversity. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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General overview for this role type — specific duties and requirements vary by employer.
Nursing roles in senior living are fundamentally different from hospital nursing. Most positions involve building long-term relationships with the same residents over months or years rather than cycling through new patients every shift. Facilities in the DFW area typically require an active Texas RN or LVN license, current CPR/BLS certification, and many prefer at least one year of geriatric or long-term care experience.
Shift patterns vary widely — some facilities run traditional 8-hour shifts (day, evening, night), while others use 12-hour rotations. Weekend and holiday coverage is almost always part of the schedule. The nurse-to-resident ratio in assisted living is generally more favorable than in hospitals, but you will likely be the highest-level clinical staff on the floor during your shift, which means more autonomy and more responsibility for clinical judgment calls.
What to Expect in This Role Day-to-Day
Based on typical senior living facilities in the DFW area.
A typical shift starts with medication pass and resident assessments. You will review overnight notes from the previous shift, check vitals for residents on your watch list, and coordinate with CNAs on any changes in condition. Mid-shift usually involves documentation, family communication, and working with physicians on care plan updates — often by phone or telehealth rather than in-person rounds.
Depending on the facility, you may also handle admissions paperwork, manage wound care, supervise medication techs, and respond to emergencies. The documentation load in senior living is significant — state surveys and compliance requirements mean thorough charting is non-negotiable. Many nurses in this setting say the most rewarding part is knowing their residents personally and being able to notice subtle changes that a rotating hospital nurse might miss.
About This Employer
ADAPTIVE HOME HEALTH
is a Branch Agency located in Richardson, TX at 1410 E. Renner Rd., Suite 210.
According to the Bureau of Labor Statistics, Registered Nurse positions in the DFW metroplex area earn a median wage of
$48.76/hr ($101,421/yr).
The typical range is $39.25 – $53.19/hr
(25th–75th percentile).
Entry Level (10th)$73,403/yr
DFW Median$101,421/yr
Experienced (90th)$129,709/yr
vs. National Median+4.0%
Source: Bureau of Labor Statistics, Occupational Employment & Wage Statistics (Dallas-Fort Worth-Arlington, TX Metro Area).
Salary data provided by DFW Senior Living Guide.
Facility Snapshot
Facility TypeBranch Agency
1410 E. Renner Rd., Suite 210, Richardson, TX 75082