https://www.mds-consultants.com/

MDS Consultants, 105 Pearl Street, Marilla, NY (2026)

02/11/2026

The Medicare Advantage ICPG—together with OIG’s General Compliance Program Guidance (GCPG) that applies to all individuals and entities involved in the health care industry—serves as OIG’s updated and centralized source of voluntary compliance program guidance for Medicare Advantage. Entities and individuals can use the ICPG to help identify their own risks and implement an effective compliance and quality program to reduce those risks.
MAOs are required to adopt and implement compliance programs that include measures that prevent, detect, and correct noncompliance with CMS’s program requirements, as well as measures to prevent, detect, and correct fraud, waste, and abuse. In its regulations, CMS identifies its expectations for core elements of the compliance programs, and its Medicare Managed Care Manual provides additional compliance program guidelines.
https://cstu.io/eab962

02/10/2026

The result of each resident interview can impact care planning, quality measures, staffing measures, and reimbursement. Based on F641, CMS utilizes various MDS audit processes that can result in financial penalties and possible “claw backs” of payments when incorrect coding of MDS items has resulted in over-payment. This “claw back” application can affect Medicare PPS reimbursement and Medicaid reimbursement based on CMI calculations. “A willfully and knowingly-provided false assessment may be indicative of payment fraud or attempts to avoid reporting negative quality measures.” (SOM, 2025, p. 247).
𝗧𝗼 𝗿𝗲𝗱𝘂𝗰𝗲 𝘁𝗵𝗲 𝗿𝗶𝘀𝗸 𝗳𝗼𝗿 𝗮𝗻𝘆 𝗼𝗳 𝘁𝗵𝗲𝘀𝗲 𝗽𝗿𝗼𝗯𝗹𝗲𝗺𝘀 𝗮𝗻𝗱 𝗼𝗽𝘁𝗶𝗺𝗶𝘇𝗲 𝗖𝗠𝗜, 𝗳𝗮𝗰𝗶𝗹𝗶𝘁𝗶𝗲𝘀 𝘀𝗵𝗼𝘂𝗹𝗱:
-𝘁𝗿𝗮𝗶𝗻 𝘀𝘁𝗮𝗳𝗳 𝘁𝗼 𝗰𝗼𝗺𝗽𝗹𝗲𝘁𝗲 𝗶𝗻𝘁𝗲𝗿𝘃𝗶𝗲𝘄𝘀 𝗯𝗮𝘀𝗲𝗱 𝗼𝗻 𝘁𝗵𝗲 𝗥𝗔𝗜 𝗺𝗮𝗻𝘂𝗮𝗹 𝗶𝗻𝘀𝘁𝗿𝘂𝗰𝘁𝗶𝗼𝗻𝘀
-𝗰𝗿𝗼𝘀𝘀 𝘁𝗿𝗮𝗶𝗻 𝗮𝗹𝘁𝗲𝗿𝗻𝗮𝘁𝗲 𝘀𝘁𝗮𝗳𝗳 𝘀𝗼 𝗶𝗻𝘁𝗲𝗿𝘃𝗶𝗲𝘄𝘀 𝗮𝗿𝗲 𝗻𝗼𝘁 𝗺𝗶𝘀𝘀𝗲𝗱 𝘄𝗵𝗲𝗻 𝗿𝗲𝗴𝘂𝗹𝗮𝗿 𝘀𝘁𝗮𝗳𝗳 𝗮𝗿𝗲 𝗼𝗳𝗳-𝗲𝗻𝘀𝘂𝗿𝗲 𝗰𝗹𝗲𝗮𝗿 𝗰𝗼𝗺𝗺𝘂𝗻𝗶𝗰𝗮𝘁𝗶𝗼𝗻 𝘄𝗶𝘁𝗵 𝘁𝗵𝗲 𝗜𝗗𝗧 𝘄𝗵𝗲𝗻 𝗔𝗥𝗗𝘀 𝗮𝗿𝗲 𝘀𝗲𝘁 𝗮𝗻𝗱 𝘄𝗵𝗲𝗻/𝗶𝗳 𝘁𝗵𝗲𝘆 𝗰𝗵𝗮𝗻𝗴𝗲-𝗮𝘂𝗱𝗶𝘁 𝗶𝗻𝘁𝗲𝗿𝘃𝗶𝗲𝘄 𝘁𝗶𝗺𝗶𝗻𝗴 𝘁𝗼 𝘃𝗲𝗿𝗶𝗳𝘆 𝘁𝗵𝗶𝘀 𝗶𝗻𝗳𝗼𝗿𝗺𝗮𝘁𝗶𝗼𝗻 𝗶𝘀 𝗰𝗼𝗹𝗹𝗲𝗰𝘁𝗲𝗱 𝗱𝘂𝗿𝗶𝗻𝗴 𝘁𝗵𝗲 𝗹𝗼𝗼𝗸𝗯𝗮𝗰𝗸 𝗽𝗲𝗿𝗶𝗼𝗱
-𝘁𝗿𝗮𝗰𝗸 𝗮𝘂𝗱𝗶𝘁 𝗳𝗶𝗻𝗱𝗶𝗻𝗴𝘀 𝗳𝗼𝗿 𝗤𝘂𝗮𝗹𝗶𝘁𝘆 𝗔𝘀𝘀𝘂𝗿𝗮𝗻𝗰𝗲 𝗮𝗻𝗱 𝗣𝗿𝗼𝗰𝗲𝘀𝘀 𝗜𝗺𝗽𝗿𝗼𝘃𝗲𝗺𝗲𝗻𝘁 (𝗤𝗔𝗣𝗜) 𝗽𝗹𝗮𝗻𝗻𝗶𝗻𝗴 𝗮𝗻𝗱 𝗽𝗼𝘁𝗲𝗻𝘁𝗶𝗮𝗹 𝗖𝗼𝗺𝗽𝗹𝗶𝗮𝗻𝗰𝗲 𝗮𝗻𝗱 𝗘𝘁𝗵𝗶𝗰𝘀 𝗰𝗼𝗺𝗺𝗶𝘁𝘁𝗲𝗲 𝗲𝘃𝗮𝗹𝘂𝗮𝘁𝗶𝗼𝗻
https://cstu.io/4a55ce

02/10/2026

The submission deadline for the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) is approaching. Minimum Data Set (MDS) assessment data and data submitted to the Centers for Medicare & Medicaid Services (CMS) via the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) for July 1 – Sept 30 (Q3) of calendar year (CY) 2025 are due with this submission deadline.
𝗔𝗹𝗹 𝗱𝗮𝘁𝗮 𝗺𝘂𝘀𝘁 𝗯𝗲 𝘀𝘂𝗯𝗺𝗶𝘁𝘁𝗲𝗱 𝗻𝗼 𝗹𝗮𝘁𝗲𝗿 𝘁𝗵𝗮𝗻 𝟭𝟭:𝟱𝟵 𝗽.𝗺. 𝗼𝗻 𝗙𝗲𝗯𝗿𝘂𝗮𝗿𝘆 𝟭𝟳, 𝟮𝟬𝟮𝟲.
It is recommended that applicable Centers for Medicare & Medicaid Services (CMS) Internet Quality Improvement and Evaluation System (iQIES) reports and NHSN analysis reports are run prior to each quarterly reporting deadline to ensure that all required data were submitted. We encourage you to verify all facility information prior to submission, including CMS Certification Number (CCN) and facility name.
https://cstu.io/d392aa
https://iqies.cms.gov/iqies

02/09/2026

The January refresh includes: Assessment-based measures reflecting data submitted by SNFs to Centers for Medicare & Medicaid Services (CMS) from Quarter 2, 2024 through Quarter 1, 2025.
-The Influenza Vaccination Coverage Among Healthcare Personnel measure reflecting data from Quarter 4, 2024 through Quarter 1, 2025.
-The CDC COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) measure and COVID-19 Vaccine: Percent of Patients Who Are Up to Date measure reflecting data from Quarter 1, 2025.
-The Potentially Preventable 30-Day Post-Discharge Readmission, Discharge to Community, and Medicare Spending Per Beneficiary claims-based measures reflecting data from Quarter 4, 2022 through Quarter 3, 2024.
-The SNF Healthcare-Associated Infections (HAI) measure reflects data from Quarter 4, 2023 through Quarter 3, 2024.
Please visit the compare tool on https://cstu.io/6c60e8 and PDC to view the updated quality data. For questions about SNF QRP Public Reporting, please email SNFQRPPRQuestions@cms.hhs.gov.
https://cstu.io/d6bfd1

02/06/2026

As the week winds down, it’s a good moment to pause and reflect.

Since the October 1, 2025 updates, many teams are still finding their footing—balancing new expectations, accuracy, documentation, and how assessments truly connect to care planning.

Change doesn’t always settle neatly, and that’s okay.

Sometimes progress starts with open conversation, shared experiences, and learning from what others are seeing on the ground. We’re looking forward to continuing that dialogue and exploring practical paths forward on February 10.

Wishing everyone a great weekend ahead!

👉https://www.mdsexpert.com/webinars-training/

02/04/2026

The January update of Appendix B to the MDS 3.0 RAI User’s Manual contains changes to the list of State RAI Coordinators, MDS Automation Coordinators, and CMS locations and contacts.
https://cstu.io/7f95ce
https://cstu.io/27dd91
https://cstu.io/12dc4f

02/04/2026

🎉 We’re kicking off our 2026 Education Year with AAPACN!

MDS Consultants is proud to begin our 2026 education year as an AAPACN Training Partner, starting with the QAPI Certified Professional (QCP®) Workshop in April 2026.

This nationally recognized workshop is designed to help facilities move beyond compliance and strengthen meaningful QAPI programs that truly impact resident care.
📅 QCP® | April 14–17, 2026
🖥️ Virtual | Eastern Time
🎓 15 Continuing Education Credits

🔗 Register at https://cstu.io/5568d2

Follow us for additional AAPACN certification opportunities throughout 2026.

02/03/2026

Since the October 1, 2025, MDS changes, many teams are still asking the same question:

“𝗪𝗵𝘆 𝗱𝗼𝗲𝘀 𝗠𝗗𝗦 𝗮𝗰𝗰𝘂𝗿𝗮𝗰𝘆 𝗳𝗲𝗲𝗹 𝗵𝗮𝗿𝗱𝗲𝗿 𝘁𝗵𝗮𝗻 𝗶𝘁 𝘂𝘀𝗲𝗱 𝘁𝗼?”

Between revised items, evolving documentation expectations, and increased survey focus on F641 – Accuracy of Assessment, the pressure is real.

𝗙𝗲𝗯 𝟭𝟬 | 𝗥𝗼𝘂𝗻𝗱𝘁𝗮𝗯𝗹𝗲: 𝗠𝗗𝗦 𝟭𝟬/𝟮𝟬𝟮𝟱 𝗖𝗵𝗮𝗻𝗴𝗲𝘀 – 𝗪𝗵𝗮𝘁 𝗔𝗿𝗲 𝘁𝗵𝗲 𝗦𝘁𝗿𝘂𝗴𝗴𝗹𝗲𝘀?

Let’s talk through what’s breaking down — and what’s working.

Register to join the conversation: https://cstu.io/0b5ad3

02/03/2026

🚨CMS is releasing the following guidance in Chapter 5 of the SOM: • Revisions to Immediate Jeopardy Priority Definition examples for Nursing Homes; and • Clarification of Off-site investigations.
CMS has updated and revised guidance in Chapter 7 of the SOM that includes: • Survey Team Composition, Survey Procedures, Plans of Correction, Verifying Corrections, Survey Revisit and Offsite Revisit Paper Review, Off-hours Survey, Enforcement, Nurse Staffing Waivers, Disposition of Civil Money Penalties (CMP), Federal Civil Penalties Inflation Reduction Act, Informal Dispute Resolution (IDR), and Independent Informal Dispute Resolution (IIDR); • Additionally, guidance previously found in Appendix P of the State Operations Manual has been added to Chapter 7; and • Technical changes that include updates for accurate references
https://cstu.io/d3689a

01/30/2026

The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2027 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and MA and Part D Payment Policies (the CY 2027 Advance Notice). This annual release proposes routine and technical updates that ensure MA and Part D payments are accurate. CMS will accept comments on the CY 2027 Advance Notice through 11:59 p.m. Eastern Time February 25, 2026, before publishing the final Rate Announcement on or before April 6, 2026.
The CY 2027 Advance Notice may be viewed at: https://cstu.io/6c045d.
To read the CMS fact sheet on the CY 2027 Advance Notice, visit: https://cstu.io/fd454c.
https://cstu.io/6d01cb

01/30/2026

Happy Friday! ☀️

A quick thank you to the administrators, nurses, MDS coordinators, and interdisciplinary team members who navigate complex regulations while keeping resident care at the center of everything they do. Your work matters.
Wishing everyone a restful and well-deserved weekend.

01/29/2026

🚨𝗥𝗘𝗠𝗜𝗡𝗗𝗘𝗥: The SNF Provider Preview Reports have been updated and are now available. These reports contain provider performance scores for quality measures, which will be published on the compare tool on https://cstu.io/a59faf and the Provider Data Catalog (PDC) during the April 2026 refresh.
Providers have until February 14, 2026, to review their performance data. Only updates/corrections to the underlying assessment data before the final data submission deadline will be reflected in the publicly reported data on https://https://cstu.io/98d400 and PDC. If a provider updates assessment data after the final data submission deadline, the updated data will only be reflected in the Facility-Level Quality Measure (QM) report and Patient-Level QM report. Updates submitted after the final data submission deadline will not be reflected in the Provider Preview Reports or on https://https://cstu.io/98d400. However, providers can request a CMS review of their data during the preview period if they believe the displayed quality measure scores within their Provider Preview Reports are inaccurate.
https://cstu.io/6c2d8b

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