The MDS Guru
Helpful tips and tricks for the MDS/ LTC Reimbursement Professional
Episodes
70 episodes
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?
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Season 2
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Episode 73
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4:48
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?
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Season 2
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Episode 72
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4:23
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?
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Season 2
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Episode 71
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5:15
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?
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Season 2
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Episode 70
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4:28
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?
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Season 2
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Episode 69
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3:29
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?
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Season 2
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Episode 68
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5:57
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?
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Season 2
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Episode 67
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4:08
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?
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Season 2
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Episode 66
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4:22
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?
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Season 2
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Episode 65
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2:56
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.
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Season 2
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Episode 64
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16:00
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.
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Season 2
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Episode 63
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20:06
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?
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Season 2
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Episode 62
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4:16
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?
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Season 2
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Episode 61
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3:55
The MDS Guru - Episode 60 - The Pressure Ulcer (L) QM
Why is this pressure sore from December listed on my January QM report?
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Season 2
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Episode 60
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4:39
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!
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Season 2
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Episode 59
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3:47
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?
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Season 2
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Episode 58
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7:04
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?
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Season 2
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Episode 57
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3:16
The MDS Guru - Episode 56 - What is the Three-Day Assessment Window to support Section GG?
What do we do about unplanned discharges? How are we supposed to have information? What if the discharge was a PPS & OBRA discharge combined, what is that time frame?
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Season 2
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Episode 56
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4:25
The MDS Guru - Episode 55 - The Timing for the Many MDS Interview Questions
When should these be signed? Before the ARD? After? Staff interview question specifics??
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Season 2
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Episode 55
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3:40
The MDS Guru - Episode 54 - Primary Medical Condition Category
What category does Covid fall into? Dementia does not belong in the neuro categories.
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Season 2
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Episode 54
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3:50
The MDS Guru - Episode 53 - Don't Find Yourself Having a One on One With The OIG-The New Surveyor Guidance for MDS
Do not find yourself having a one on one with the OIG! Who decides if the MDS person purposely miscoded an assessment?
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Season 2
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Episode 53
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3:52
The MDS Guru - Episode 52 - How to Validate Section GG Responses on the MDS for Missouri Medicaid
I have my ADL charting in the notes, is that good enough? Make sure you are using the ARD and two previous days for your ADL assessments!
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Season 2
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Episode 52
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5:18
The MDS Guru - Episode 51 - Should I code isolation for CDIFF? What about MDRO's?
When should isolation be coded? What are the constituents of an MDRO?
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Season 2
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Episode 51
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5:46