# MDS-PDPM Documentation Validation Sample (PDF)

> An MDS item against supporting chart evidence table for a 5-day PPS assessment: item, coded value, supporting note and page, gap flag. No coding advice. Free sample PDF.

Canonical page: https://medrecords.ai/content-hub/samples/mds-pdpm-documentation-validation-sample/

---
[Content Hub](https://medrecords.ai/content-hub/) › [Samples](https://medrecords.ai/content-hub/samples/) › Records Management & Q&A

## MDS-PDPM Documentation Validation Sample

MDS-PDPM documentation validation sample for a fictional 5-day PPS assessment: each coded MDS item set against the chart note that supports it, with the page, and a flag where support is partial, absent or in conflict with another note. It covers sections I, GG, K, O, C, D, M and N. No coding advice.

By [Ahmed Jemaa](https://medrecords.ai/authors/ahmed-jemaa/), Co-Founder & CEO of Medrecords AI · Published 8 Oct 2026

Birchwood Rehabilitation (fictional) — 5-day PPS assessment — ARD 03/12/2026

### What’s inside

- MDS item, coded value, supporting note and page in 1 table
- Gap flags: supported, partial, not found, conflict
- Function (section GG), diagnoses (section I), nutrition, special treatments and mood items checked against the chart
- Items where 2 notes disagree, listed side by side

This is a real Medrecords AI work product on a fictional, company-branded demo case, not a template or a mockup. Open the PDF to see the actual formatting, citations, and structure a case team receives.

[](https://medrecords.ai/assets/samples/pdf/mds-pdpm/mds-pdpm-documentation-validation-sample.pdf)
[Download the PDF ](https://medrecords.ai/assets/samples/pdf/mds-pdpm/mds-pdpm-documentation-validation-sample.pdf)

### How Medrecords AI does this work

See how Medrecords AI checks each coded MDS item against the chart and flags the ones the notes do not support.

[Solution — **MDS and PDPM documentation validation** — Every coded item checked against the chart that has to support it, with the page. Read more →](https://medrecords.ai/solutions/mds-pdpm-documentation-validation/) [Product — **Missing records identification** — Flags where the note that should exist is not in the file. Read more →](https://medrecords.ai/product/missing-records-identification/) [Browse — **All 48 samples and tools** — Reports, chronologies, expert opinions, plus free templates and tools. Read more →](https://medrecords.ai/content-hub/samples/)
Test it on a file you already have.
Send one real record set. You get back a cited draft and decide for yourself whether the read holds up. No obligation either way.
[Book a demo](https://medrecords.ai/demo/) [See pricing](https://medrecords.ai/pricing/)

### More from Records Management & Q&A

[PDF Sorting & Indexing Sample](https://medrecords.ai/content-hub/samples/medical-records-pdf-sorting-indexing-sample/) [Missing Records Request List Sample](https://medrecords.ai/content-hub/samples/missing-medical-records-request-list-sample/) [Treating Providers List Sample](https://medrecords.ai/content-hub/samples/treating-providers-list-sample/) [Medical Record Q&A Sample](https://medrecords.ai/content-hub/samples/medical-record-qa-sample/)
Last verified: 2026-10-08 · [← All samples](https://medrecords.ai/content-hub/samples/)

### More sample deliverables

- [**Medical Causation Expert Opinion Sample** — A causation-only expert opinion draft for a personal-injury collision case, reasoned to a medical probability…](https://medrecords.ai/content-hub/samples/medical-causation-expert-opinion-sample/)
- [**Medical Chronology With Bills Sample** — A treatment chronology reconciled against the billing ledger, so every visit shows what was billed and paid.…](https://medrecords.ai/content-hub/samples/medical-chronology-with-bills-sample/)
- [**Medical Malpractice Chronology Sample** — A chronology tracking a post-operative infection from onset through septic shock and revision surgery. Free…](https://medrecords.ai/content-hub/samples/post-operative-infection-medical-malpractice-chronology-sample/)
- [**Medical Record Q&A Sample** — 12 case-specific questions answered directly from the record, every answer cited to its source page. Free…](https://medrecords.ai/content-hub/samples/medical-record-qa-sample/)
- [**Medical record review cost calculator** — Estimate a medical record review across the published pricing models: per page, per hour and per case. Free…](https://medrecords.ai/content-hub/samples/medical-record-review-cost-calculator/)
- [**Medicare Lien Summary Sample** — A conditional payment summary identifying Medicare-related charges from the record and EOBs, reconciled to…](https://medrecords.ai/content-hub/samples/medicare-lien-conditional-payment-summary-sample/)