Ask the payment expert ... about inaccurate MDS therapy information

Share this article:
Patricia Boyer
Patricia Boyer

What happens if my therapy company makes an error on the MDS and as a result, a change of therapy was missed? Are we still responsible?

You are responsible for any information on the MDS. You should, however, hold your therapy company responsible for accuracy of information on the MDS. 

Make sure they are signing Section Z of the MDS. This holds them responsible for the accuracy of the information. In addition, you need to make sure any contract therapy agreement has an indemnification clause that holds therapy responsible if you have a denial.

Also hold them responsible for information that creates a billing error. The one thing to remember is that most indemnification clauses only hold the therapy company responsible for the amount you paid them if you have a denial. You would still lose your room and board coverage. 

You are legally responsible for all information you submit for billing. Therefore, it is highly advisable that you have a triple-check process in place through which you are validating all the information on the bill prior to submission. That should include verification that needed Change of Therapy (COT) assessments were completed. 

Another strategy is to have your MDS coordinator and therapy leaders talk daily to review any resident who has missed any therapy. They also should review anyone who is on their seventh day of the COT observation period to verify minutes are correct. 

Share this article:

More in News

Double homicide at Houston nursing home; victims' roommate arrested

Double homicide at Houston nursing home; victims' roommate ...

A double murder occurred late Tuesday night in a Houston nursing home room shared by four men, according to local authorities. Police arrested Guillermo Correa on suspicion of beating two ...

$2 million HIPAA settlement highlights mobile device risks facing healthcare providers

Laptops and other mobile devices containing personal health information have been stolen from long-term care ombudsman programs and other healthcare organizations, including from Concentra Health Services and QCA Health Plan Inc. Now, Concentra and QCA have agreed to legal settlements totaling nearly $2 million, federal ...

Long-term care nurses often 'scramble' to get family members' blessing for palliative ...

Nursing home residents might not transition to full palliative care until they are very near death, at which point nurses and family members act in a state of crisis, suggests recently published research out of Canada.