Section GG accuracy, held to a fixed reference point.
Know your MDS coding holds up before an auditor checks it. RN-led reviews of each assessment against the chart, at a flat monthly fee, reporting what's under- and over-documented, so your payments and star ratings rest on documentation that holds up.
Every point on Section GG changes the claim, in either direction.
PDPM ties reimbursement directly to functional scoring and clinical category — which means a single mis-scored self-care or mobility item doesn't just risk an audit finding later. It changes the per diem rate today.
Case-mix, not just compliance
An inaccurate score doesn't only create audit exposure — it can under- or over-state a resident's PDPM group immediately, on the very claim it's submitted with.
Most facilities have no second reviewer
A 2–10 building operator rarely has budget for a full-time MDS/PDPM specialist, so scoring goes out the door reviewed once, by the person who entered it.
Pricing shouldn't be a mystery
Most audit firms in this space gate pricing behind a sales call. We publish ours, because a flat, known rate is easier to budget against than a quote.
One monthly audit cycle, three things checked.
A defined sample of MDS assessments per facility, reviewed against the same standard your own PPS coordinator is held to.
Section GG scoring
Functional (self-care & mobility) items checked against the supporting clinical documentation on file.
Item-level findings, flagged by direction of risk (under- or over-scored).
PDPM classification
Case-mix group placement across all PDPM components, traced back to the MDS items driving it.
A classification-accuracy summary with the case-mix impact of each flagged item.
Documentation completeness
Whether the clinical record actually supports what was coded, not just whether a field was filled in.
A written findings report with dollar-impact estimates, delivered on a fixed monthly date.
Four steps, on repeat every month.
Secure access
Read-only access in your own EHR under a signed BAA. Records stay in your system, never in a generic form or shared drive.
Clinical review
A licensed RN with PPS/MDS coordination experience reviews the sample against Section GG and PDPM standards.
Findings report
Item-level findings with dollar-impact estimates, organized by resident and by risk direction, plus an accuracy trend over time.
Monthly cadence
The same process repeats each cycle, so trends across residents and MDS coordinators surface over time.
Published flat rates — not a quote form.
Flat monthly fee per facility. Our fee never depends on what we find or on reimbursement. Plans run an initial three months, then month to month.
- 10 assessments reviewed a month
- Monthly findings report
- 20 assessments reviewed a month
- Monthly findings report
- 30-minute monthly call with your DON
- Quarterly QM Accuracy Review
- 30 assessments reviewed a month
- Report, monthly call and quarterly QM Accuracy Review
- Monthly Triple Check review
Baseline audit
Documentation review of 25 assessments, findings in both directions, a short lookback, a written report and a walkthrough call.
$1,950
QM Accuracy Review
The MDS items behind each MDS-based quality measure checked against the chart, with a public-data star snapshot.
$750–1,000
Triple Check Setup
Checklist, roles, meeting agenda and tracking log, plus the first monthly meeting facilitated by our RN.
$1,500–2,500
Several buildings? Owners and management companies with 3–4 buildings get 5% off each building's monthly plan. With 5 or more, it's 10% off (Essentials $675, Standard $1,125, Plus $1,575) plus a free quarterly portfolio summary comparing all your buildings. Once your coding is consistently clean, you can step down to Essentials instead of stopping.
The baseline audit is a flat $1,950. Before quoting, we review 2 sample assessments at no charge; if your records need extra work to review, the complex-records baseline is a flat $2,950 for the same 25 assessments. QM Accuracy Review and Triple Check Setup prices within each range depend on facility size and are fixed in the order form before work begins.
Resident data is PHI. We treat it that way from day one.
No assessment data moves through a generic form, spreadsheet tool, or general-purpose AI product. Infrastructure and process are built around the same obligations your facility already operates under.
- Signed Business Associate Agreement (BAA) before any resident-level data is shared.
- De-identification available for an initial sample review, before a full engagement begins.
- Findings reports name items and scores only — never used for any purpose beyond the audit itself.
- Review scope and access are limited to what the audit requires — nothing broader.
Clinical judgment, paired with review and business discipline.
Maria
A licensed registered nurse with hands-on experience overseeing Section GG scoring and PDPM classification inside a skilled nursing facility — the same standard applied here is the one used on the floor.
Angela
Handles contracts, BAAs, onboarding, scheduling and billing, so every engagement starts on time and runs on a fixed monthly calendar once a facility signs on.
Robert
Your point of contact from first conversation to an active monthly engagement. Background running quality-assurance workflows for a commercial claims review team, applied here to the intake process, review cadence, and reporting that make a monthly audit repeatable.