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SNF MDS 3.0 & PDPM VALIDATION

The assessment says one thing. The chart has to say it too.

MDS 3.0 validation services check the coded assessment items against the documentation behind them: function scores, active diagnoses, and services delivered in the look-back window. Unsupported items are flagged with the PDPM classification impact shown, and the correction decision stays with your MDS coordinator.

Click any row → the source page it cites
Item validation · Case #IME-4812 documented
Adams, Timothy · MDS assessment and chart
342 pp / 2 packets received logged
11 duplicate pages removed free
p.140 — wrong patient quarantined
Pages 342 Documents 27 Cited 100%

The RAI manual is published. So is the auditor who applies it.

We do not build for a case type until we can name the standard that defines a correct output and the person who grades the file against it. In MDS and PDPM, both are already published.

The standard and the referee
The rulebook
  • The CMS Long-Term Care Facility RAI User's Manual, which defines every MDS item, its look-back period, and its coding instructions
  • The PDPM classification logic, which maps MDS items to the PT, OT, SLP, nursing and NTA components
  • The ICD-10-CM mapping CMS publishes for the primary diagnosis clinical category
  • 42 CFR §483.20, which requires the assessment to accurately reflect the resident's status
The referee
  • The MAC and the Supplemental Medical Review Contractor, on targeted probe and educate and on additional documentation requests
  • The HHS Office of Inspector General, whose SNF billing audits target unsupported PDPM components
  • The state survey agency, where an inaccurate assessment is a deficiency under §483.20
Repayment on an audited claim, plus the extrapolation that can follow it Flat 10¢/page here, duplicates free
Item validation · Case #IME-4812 cited 100%
Packet342 pp / 2 packets · 11 deduplicatedlogged
Coded itemsChecked against the look-back chartcited
Function scoresDocumentation across the observation dayscited
Unsupported itemsCoded with nothing behind itflagged
Validation delivered · cited 100% · no MDS coded or submitted
How it works

3 steps between the assessment and the claim.

01

Send the MDS and the chart

The completed assessment plus the clinical record covering each item's look-back window, in any format.

02

We return the validation, page-cited

Each coded item matched to the documentation supporting it, with unsupported items flagged and the PDPM component each one drives identified.

03

Your coordinator decides

Coding, correction, and submission stay with your MDS coordinator and your compliance team. We never code an item or transmit an assessment.

The boundary, in writing

A check against the chart, not a coded assessment.

We compare the coded items to the documentation in each look-back window and cite what supports them. We do not code the MDS, complete or correct an assessment, transmit to CMS, or determine a payment rate. Those are your MDS coordinator's and compliance team's responsibilities.

Validation runs in both directions. Items the chart supports more strongly than they were coded are flagged too, because a facility that only ever finds errors in its own favour has built the wrong control.

Audit trail · Case #IME-4812 exportable
08:12Packet received · 342 pp / 2 packetssystem
08:3111 pages deduplicatedsystem
08:44p.140 flagged — wrong patientsystem
08:54Item validation complete · validation complete · items checked · cited 100%system
09:20Item validation reviewed · citations verifiedreviewer
09:26Item validation exported · correction decision made off-platformreviewer
Every access logged · file deleted 30 days after delivery
Why Medrecords AI

The rules the platform never breaks.

Medrecords AI EVERY LINE CITED
CASE #IME-4812 · ADAMS, T.342 pp
2/14 — ER visit, right knee p.4
4/18 — arthroscopic surgery p.61
p.140 — wrong patient quarantined
Medrecords AI
Read every page · cite every line

HIPAA, under a signed BAA

Every file is handled under our Business Associate Agreement, from the first byte.

Never trains a model

Your records are never used to train any AI model — ours or anyone else's.

Every line cited

If we can't cite it, we don't say it. Every sentence links to its source page.

Deleted after delivery

Files are deleted 30 days after delivery, with a full audit log of every access.

Powered by the platform

4 capabilities behind every item validation.

The item validation is 1 deliverable of the same platform that reads, sorts, and cites the whole record.

FAQ

MDS and PDPM validation, answered.

No. We check the coded items against the documentation in each look-back window and cite it. Coding, completing or correcting an assessment, and transmitting it to CMS stay with your MDS coordinator under the RAI manual.

It identifies which PDPM component each flagged item drives, so the significance of a correction is visible. Calculating the rate and deciding what to do about a claim is your compliance team's call, not ours.

No. Items the chart supports more strongly than they were coded are flagged as well. A validation that only ever finds errors in one direction isn't a control, and an auditor will read it that way.

No. Medrecords AI does not retrieve records from providers or facilities. You bring the records you already have — review starts in minutes from upload. Retrieval vendors take days; you can keep yours and still cut the review to minutes.

Send 1 file. We'll tell you what we can read.

No obligation. If the case type is buildable we'll scope it; if it isn't, we'll say so.