Ensuring Your Moderate Level of Service Meets the Coding Criteria

Does your documentation match your moderate level of service billed?  With the changes implemented by the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS), it is very important to make sure your documentation matches the level of service you are billing.  Many providers are finding themselves billing more moderate level of service visits now than they did previously under the old guidelines.   Criteria for Code Selection To achieve a moderate level of service, at…

Understanding Minimum Data Set (MDS) Validation

The Minimum Data Set (MDS) is a federally mandated assessment used in Medicare or Medicaid-certified nursing homes to evaluate a resident’s functional abilities and healthcare needs. The MDS incorporates standardized elements, coding categories, and vital health indicators. Validating the MDS is an essential step for skilled nursing facilities (SNFs) that is sometimes bypassed. The validation process ensures the accuracy of the data submitted to the Centers for Medicare & Medicaid Services (CMS). The MDS coordinator,…

Understanding the Benefits of Performing a Mock Survey

Whether your organization relies on an in-house team or enlists the help of an outside consultant, conducting a mock survey is an essential strategy to assess your organization’s current performance against the standards set by the Centers for Medicare & Medicaid Services (CMS), improving your chances of securing a higher star rating. In 2025, healthcare providers are still navigating the long-term impacts of the COVID-19 pandemic, alongside new challenges like workforce instability, ongoing staffing shortages,…