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Discussion

State audits of MDS

Just curious about how other states might audit the MDS for payment. Here in Minnesota it is usually one time a year.

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here in indiana it is annual but they told me they have the option to come anytime. they are not strictly bound to annual.

The UMR team from the Dept. of Health and Welfare come in quarterly. They used to do MDS reviews twice- 15 records one time, and 5 another (They focus on billing and OBRA also). Now, they review 20 records. If our results are good (I'm happy to report that they are!), they only do MDS review the one time a year.

In Indiana it is usually once a year but they have a 15 month window from your last audit to come in. If for some reason your CMI increases drastically or the notice anything odd in the patterns of your MDS submissions they can come in at anytime. Word is out though that Meyers and Stauffers is going to take over EDS' contract in the future. It is at least nice of them, they call the day before they come into the facility.

Yes, thankfully UMR gives us a 1-2 week notice before they come in, and they give us a list of the MDS they will be reviewing.

We get a call the night before asking for a list of MI residents, traumatic brain injuries, stage 3 or 4 wound ( none thank godness) and a resident roster. No list of which MDS though. that would be nice.

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Ours has a window too. They come unannounced.

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