Section GG accuracy, held to a fixed reference point.
Independent monthly review of MDS assessments and PDPM classification — clinical-led, priced openly, and reported in dollars, not just checkboxes.
Every point on Section GG moves real money.
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 intake
Assessments are shared through a HIPAA-compliant channel under a signed BAA — never 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.
Monthly cadence
The same process repeats each cycle, so trends across residents and MDS coordinators surface over time.
Published rates, scaled to census — not a quote form.
Flat monthly retainer per facility. Exact sample size and price are confirmed at contract, but the range below is real, not a placeholder.
- One building
- Defined monthly sample of assessments
- Full written findings report
- 2–5 facilities
- Volume-adjusted per-facility rate
- Portfolio-level trend summary
- 6–10 facilities
- Dedicated review cycle & reporting calendar
- Priority scheduling for new findings
Rates reflect the current launch pricing model and scale with sample size and facility census.
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 discipline.
RN & PPS Coordinator
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.
Review Systems & Delivery
Background running quality-assurance workflows for a commercial claims review team, applied here to build the intake process, review cadence, and reporting that make a monthly audit repeatable.