The MDS Guru
Helpful tips and tricks for the MDS/ LTC Reimbursement Professional
Episodes
76 episodes
The MDS Guru - Episode 79 - NO PROGRESS, NO THERAPY? KNOW WHEN TO STOP THERAPY.
Stop guessing: When should I take my resident off of therapy? SKILLED NEED VS PROGRESS PLATEAUS
The MDS Guru - Episode 78 - SNF ABN|NOMNC|ABN & FALL DEFINITION CHANGES + MAJOR ANNOUNCEMENT
When to issue a SNF ABN vs a NOMNC or ABN? What are the changes to the definition of a fall?
The MDS Guru - Episode 77 - The SFF Criteria Change & The QRP APU Trap-When One MDS Counts as 2
What could get my facility terminated from the Medicare/Medicaid program?How does the 5-day PPS MDS count as two assessments for the QRP APU?
The MDS Guru - Episode 76 - The Updated SNF Validation Process (AUDIT) Timeline Shift
What happens if we are late submitting the medical records? How will I know if my home is selected?
The MDS Guru - Episode 75 - The Many Look Back Periods on the MDS
The MDS has several look back periods. Do you know what they are?
The MDS Guru - Episode 74 - How Will the Missouri Medicaid CMI Be Calculated When New Assessments Are Not Supported In 2026
Do the assessments automatically drop to .62 CMI if they are not supported? Do you know what a hierarchical method of CMI classification is?
The MDS Guru - Episode 73 - The NEW 1-1-26 Exclusion for the (L) Antipsychotic Med QM + The Conclusion of our QM Series-Prevalence of Falls & Behavior Symptoms Affecting Others (L)
What new item will stop the antipsychotic med (L) QM from triggering?What is the updated RAI definition regarding a fall?
The MDS Guru - Episode 72 - How To Claim Isolation for Covid on the MDS
What is needed in my documentation for Covid to claim isolation on the MDS?What if my MDS interview signatures are late?
The MDS Guru - Episode 71 - Number of Outpatient ED Visits per 1000 (L) Resident Days & (L) % of Residents With New or Worsened Bowel or Bladder Incontinence QMs
My resident's ER visit turned into an admission. Will this ER visit trigger this QM? My resident's cognition changed from a stroke, will his worsening continence trigger this?
The MDS Guru - Episode 70 - (S) & (L) - % of Residents Assessed and Given the Seasonal Influenza & Pneumococcal Vaccines + (S) % of Residents Who Newly Received an Antipsychotic Med + (L) % of Residents Physically Restrained QMs
When is the Influenza season for the MDS? If your resident is using bedrails, you do not want to miss this! What determines the criteria for "current" for the pneumococcal vaccinations?
The MDS Guru - Episode 69 - % of Residents Who Use Antianxiety or Hypnotic Meds(L) & Prevalence of Antianxiety/Hypnotic Use(L) QMs
An appropriate anxiety diagnosis clears one of these QM triggers, do you know which one? Hospice is an exclusion for one of them. Which one?
The MDS Guru - Episode 68 - % of Residents With Depressive Symptoms(L) & Residents Ability to Walk Independently Worsened(L) QMs
What makes the depression symptoms QM trigger?What if my resident is hospice and stops walking?
The MDS Guru - Episode 67 - Residents Experiencing One or More Falls With Major Injury (L) & Residents Who Lose Too Much Weight (L) QMs
How do I get rid of this fall with major injury on my QM report? Can I use CHF as an exemption for my weight loss QM?
The MDS Guru - Episode 66 - The (L) Percent of Residents Who Have/Had a Catheter Inserted & Left in Bladder & (L) % of Residents with a UTI QMs
How can I get this foley to not trigger? And this UTI? Should I capture this on the MDS?
The MDS Guru - Episode 65 - The Missouri Medicaid Draft Listing Mix-Up
We uncover how dually eligible residents should be listed on your draft rate corrections for Missouri. Are you losing CMI from part A residents?
The MDS Guru - Episode 64 - MANHA's Executive Director Speaks
A conversation with Dottie Pataky, RN, the ED of the Missouri Association of Nursing Home Administrators. Listen as we discuss the present, the future and some challenges of our LTC world.
The MDS Guru - Episode 63 - A Reimbursement Reality Check: A SNF Administrator's Perspective
We are joined by Dee Shaffer, a dually Missouri & Kansas licensed admin. What works for her facility to navigate the complex world of Medicare & Medicaid.
The MDS Guru - Episode 62 - The Need for Help with Daily Activities has Increased (L) QM
Why did this trigger when I answered the late loss ADL's as not attempted due to medical condition? Wait, this resident only declined in one area, why did this also trigger?
The MDS Guru - Episode 61 - The Antipsychotic Med (L) QM
What can I do about this long stay QM flag? What are the exclusions? How can I get my provider to stop using these?
The MDS Guru - Episode 60 - The Pressure Ulcer (L) QM
Why is this pressure sore from December listed on my January QM report?
The MDS Guru - Episode 59 - The Admission Function Score
Do you know what the entry/admission function score is? It is part of the Discharge Function Score. Tune in now!
The MDS Guru - Episode 58 - Section I Diagnosis Coding and Reporting Nurses to the State Board for Coding
Let's talk about section I diagnosis coding. How do we not get into trouble?
The MDS Guru - Episode 57 - THERE IS A THIRD MDS DRAFT FOR OCTOBER 2025 NOW!
Are we getting a section R? What about all the therapy question changes?