CMI review
Evaluation of case mix drivers so resident acuity is accurately reflected, without exposing the facility to compliance risk.
MDS & reimbursement
MDS and PDPM support when you need it most
Your MDS drives reimbursement, care planning, Five-Star quality measures, and survey defensibility. When assessments fall behind or accuracy slips, revenue and compliance both suffer. We get it back on track.
48 hrsto an experienced MDS nurse on your assessments
$150Kaverage PDPM revenue recovered
RAC-CTcertified MDS consultants
Nolong-term contract required
48-hour MDS nurse guarantee
An MDS nurse assigned to your building within 48 hours
MDS coordinator out, resigned, or buried in assessments? We assign an experienced MDS nurse within 48 hours of a signed agreement. Remote support through secure EHR access, onsite when you need it. Pay for what you need, with no long-term contract.
Coverage
Fill-in MDS coverage
Admission, 5-day, quarterly, annual, significant change, and Interim Payment Assessments, with complete Care Area Assessment documentation and care plan updates.
Multi-facility
Regional MDS support
Backup coverage across several buildings, standard processes, and a regional view of case mix, timeliness, and accuracy.
Accuracy
MDS auditing
Assessment and documentation audits that find coding gaps, unsupported items, and missed reimbursement before a reviewer does.
Billing
Triple Check training
Teach your team to reconcile the MDS, nursing and therapy documentation, and the claim before it goes out, so errors are caught before billing.
Team process
Medicare meeting training
Run a weekly Medicare meeting that works: skilled need, assessment reference dates, Interim Payment Assessment triggers, documentation, and discharge planning.
Medicare reviews
Additional documentation request help
When Medicare asks for records to support a claim, we build the response package and check it against the MDS and billing. See how we help.
PDPM optimization
Capture the reimbursement your residents’ acuity supports
Missed NTA points, coding gaps, and CMI underperformance can cost a building $3,000 to $5,000 a month. Facilities we support have moved daily rates from about $350 to $650 or more when documentation supported it.
NTA & SLP capture
Documentation and coding practices that capture every Non-Therapy Ancillary and SLP component the record supports.
Documentation improvement
Clinical and MDS documentation that is accurate, consistent, and defensible on review.
Audit defense
Preparation for SNF validation audits, TPE, and other Medicare review, reducing exposure to recoupment.
Monthly MDS audits
Ongoing audits that find missed opportunities and errors before claims go out.
Full department oversight
Complete MDS department management, SNF QRP and VBP monitoring, and regional coordination.
Medicare additional documentation requests (ADR)
Received an ADR? You have 45 days.
When a Medicare contractor sends an additional documentation request, the facility has 45 days to send records that prove the claim was medically necessary, skilled, and coded correctly. If the records do not arrive in time, the claim is denied automatically on day 46. A complete response the first time is far cheaper than an appeal.
- 01
Review the request
We confirm what was requested, the claim dates, and your exact due date.
- 02
Check the MDS against the record
We compare the assessment, nursing and therapy notes, and physician orders to the billed payment group.
- 03
Build the response package
Organized, indexed records with a cover letter that points the reviewer to the evidence of skilled need.
- 04
Fix the root cause
We tie findings back to Triple Check and your Medicare meeting so the same gap does not draw the next request.
MDS leadership, education & training
Strong MDS programs are built, not inherited
For facilities that want more than completed assessments: an MDS process that works long term.
- New or developing MDS coordinators
- Experienced MDS nurses who need structure
- Regional and corporate leaders overseeing multiple buildings
- Organizations with turnover or repeat survey issues
- Teams preparing for survey, audit, or PDPM review
Case-based coaching using your real assessments, regional standardization, and PDPM education for clinical and leadership audiences. Self-paced MDS training is also available.
FAQ
Common questions
How fast can you start?
Emergency situations are often covered the same day. We guarantee a qualified MDS nurse working on your assessments within 48 hours of a signed agreement and EHR access.
Do you handle IDR support?
Yes. We prepare informal dispute resolution documentation and support appeals.
Do you work remotely or onsite?
Both. Most MDS coverage is remote through secure EHR access. Audits, training, and interim coverage can be onsite.
Do you require a long-term contract?
No. Coverage can be short term. Ongoing auditing and department oversight are available on monthly agreements.
What is a Medicare additional documentation request?
A request from a Medicare contractor for records that support a claim you billed. Skilled nursing facilities have 45 days to respond, and claims without a timely response are denied.
Can you help with Triple Check and our Medicare meeting?
Yes. We train MDS, nursing, therapy, and business office staff on Triple Check and on running an effective weekly Medicare meeting, onsite or remote.
Ready to get your MDS back on track?
Call to set up your 48-hour MDS agreement, or start with a free MDS audit.