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Understanding the Financial Forces Shaping MDS Decisions The Patient-Driven Payment Model (PDPM) was implemented to correct long-standing issues in skilled nursing facility (SNF) reimbursement. In theory, PDPM shifts payment away from therapy volume and toward resident clinical complexity. In practice, however, PDPM has introduced a new set of financial pressures and incentives that directly influence…

Inaccurate MDS data is one of the most overlooked threats to quality measures, Five-Star ratings, and Medicare reimbursement in skilled nursing facilities. Because the Minimum Data Set (MDS) drives nearly every quality metric reported to Centers for Medicare & Medicaid Services, even small coding errors can create widespread financial and regulatory consequences. This article explains…

What Is MDS Fraud vs. MDS Error? Key Differences Every MDS Coordinator Should Know MDS fraud vs. MDS error is one of the most misunderstood topics in skilled nursing facilities — and one of the most dangerous to ignore. The Minimum Data Set (MDS) directly impacts: Yet many facilities blur the line between honest MDS…