PODCAST · education
The MDS Guru
by Melinda Renshaw|RN|RAC-CTA|LNHA|Revenue Integrity Specialist
Helpful tips and tricks for the MDS/ LTC Reimbursement Professional
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76
The MDS Guru - Episode 79 - NO PROGRESS, NO THERAPY? KNOW WHEN TO STOP THERAPY.
Send us Fan MailStop guessing: When should I take my resident off of therapy? SKILLED NEED VS PROGRESS PLATEAUS
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75
The MDS Guru - Episode 78 - SNF ABN|NOMNC|ABN & FALL DEFINITION CHANGES + MAJOR ANNOUNCEMENT
Send us Fan MailWhen to issue a SNF ABN vs a NOMNC or ABN? What are the changes to the definition of a fall?
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74
The MDS Guru - Episode 77 - The SFF Criteria Change & The QRP APU Trap-When One MDS Counts as 2
Send us Fan MailWhat could get my facility terminated from the Medicare/Medicaid program?How does the 5-day PPS MDS count as two assessments for the QRP APU?
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73
The MDS Guru - Episode 76 - The Updated SNF Validation Process (AUDIT) Timeline Shift
Send us Fan MailWhat happens if we are late submitting the medical records? How will I know if my home is selected?
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72
The MDS Guru - Episode 75 - The Many Look Back Periods on the MDS
Send us Fan MailThe MDS has several look back periods. Do you know what they are?
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71
The MDS Guru - Episode 74 - How Will the Missouri Medicaid CMI Be Calculated When New Assessments Are Not Supported In 2026
Send us Fan MailDo the assessments automatically drop to .62 CMI if they are not supported? Do you know what a hierarchical method of CMI classification is?
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70
The MDS Guru - Episode 73 - The NEW 1-1-26 Exclusion for the (L) Antipsychotic Med QM + The Conclusion of our QM Series-Prevalence of Falls & Behavior Symptoms Affecting Others (L)
Send us Fan MailWhat new item will stop the antipsychotic med (L) QM from triggering?What is the updated RAI definition regarding a fall?
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69
The MDS Guru - Episode 72 - How To Claim Isolation for Covid on the MDS
Send us Fan MailWhat is needed in my documentation for Covid to claim isolation on the MDS?What if my MDS interview signatures are late?
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68
The MDS Guru - Episode 71 - Number of Outpatient ED Visits per 1000 (L) Resident Days & (L) % of Residents With New or Worsened Bowel or Bladder Incontinence QMs
Send us Fan MailMy resident's ER visit turned into an admission. Will this ER visit trigger this QM? My resident's cognition changed from a stroke, will his worsening continence trigger this?
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67
The MDS Guru - Episode 70 - (S) & (L) - % of Residents Assessed and Given the Seasonal Influenza & Pneumococcal Vaccines + (S) % of Residents Who Newly Received an Antipsychotic Med + (L) % of Residents Physically Restrained QMs
Send us Fan MailWhen is the Influenza season for the MDS? If your resident is using bedrails, you do not want to miss this! What determines the criteria for "current" for the pneumococcal vaccinations?
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66
The MDS Guru - Episode 69 - % of Residents Who Use Antianxiety or Hypnotic Meds(L) & Prevalence of Antianxiety/Hypnotic Use(L) QMs
Send us Fan MailAn appropriate anxiety diagnosis clears one of these QM triggers, do you know which one? Hospice is an exclusion for one of them. Which one?
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65
The MDS Guru - Episode 68 - % of Residents With Depressive Symptoms(L) & Residents Ability to Walk Independently Worsened(L) QMs
Send us Fan MailWhat makes the depression symptoms QM trigger?What if my resident is hospice and stops walking?
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64
The MDS Guru - Episode 67 - Residents Experiencing One or More Falls With Major Injury (L) & Residents Who Lose Too Much Weight (L) QMs
Send us Fan MailHow do I get rid of this fall with major injury on my QM report? Can I use CHF as an exemption for my weight loss QM?
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63
The MDS Guru - Episode 66 - The (L) Percent of Residents Who Have/Had a Catheter Inserted & Left in Bladder & (L) % of Residents with a UTI QMs
Send us Fan MailHow can I get this foley to not trigger? And this UTI? Should I capture this on the MDS?
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62
The MDS Guru - Episode 65 - The Missouri Medicaid Draft Listing Mix-Up
Send us Fan MailWe uncover how dually eligible residents should be listed on your draft rate corrections for Missouri. Are you losing CMI from part A residents?
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61
The MDS Guru - Episode 64 - MANHA's Executive Director Speaks
Send us Fan MailA conversation with Dottie Pataky, RN, the ED of the Missouri Association of Nursing Home Administrators. Listen as we discuss the present, the future and some challenges of our LTC world.
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60
The MDS Guru - Episode 63 - A Reimbursement Reality Check: A SNF Administrator's Perspective
Send us Fan MailWe are joined by Dee Shaffer, a dually Missouri & Kansas licensed admin. What works for her facility to navigate the complex world of Medicare & Medicaid.
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59
The MDS Guru - Episode 62 - The Need for Help with Daily Activities has Increased (L) QM
Send us Fan MailWhy did this trigger when I answered the late loss ADL's as not attempted due to medical condition? Wait, this resident only declined in one area, why did this also trigger? www.renshawconsulting.com
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58
The MDS Guru - Episode 61 - The Antipsychotic Med (L) QM
Send us Fan MailWhat can I do about this long stay QM flag? What are the exclusions? How can I get my provider to stop using these?
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57
The MDS Guru - Episode 60 - The Pressure Ulcer (L) QM
Send us Fan MailWhy is this pressure sore from December listed on my January QM report?
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56
The MDS Guru - Episode 59 - The Admission Function Score
Send us Fan MailDo you know what the entry/admission function score is? It is part of the Discharge Function Score. Tune in now!
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55
The MDS Guru - Episode 58 - Section I Diagnosis Coding and Reporting Nurses to the State Board for Coding
Send us Fan MailLet's talk about section I diagnosis coding. How do we not get into trouble?
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54
The MDS Guru - Episode 57 - THERE IS A THIRD MDS DRAFT FOR OCTOBER 2025 NOW!
Send us Fan MailAre we getting a section R? What about all the therapy question changes?
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53
The MDS Guru - Episode 56 - What is the Three-Day Assessment Window to support Section GG?
Send us Fan MailWhat do we do about unplanned discharges? How are we supposed to have information? What if the discharge was a PPS & OBRA discharge combined, what is that time frame?
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52
The MDS Guru - Episode 55 - The Timing for the Many MDS Interview Questions
Send us Fan MailWhen should these be signed? Before the ARD? After? Staff interview question specifics??
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51
The MDS Guru - Episode 54 - Primary Medical Condition Category
Send us Fan MailWhat category does Covid fall into? Dementia does not belong in the neuro categories.
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50
The MDS Guru - Episode 53 - Don't Find Yourself Having a One on One With The OIG-The New Surveyor Guidance for MDS
Send us Fan MailDo not find yourself having a one on one with the OIG! Who decides if the MDS person purposely miscoded an assessment?
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49
The MDS Guru - Episode 52 - How to Validate Section GG Responses on the MDS for Missouri Medicaid
Send us Fan MailI have my ADL charting in the notes, is that good enough? Make sure you are using the ARD and two previous days for your ADL assessments!
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48
The MDS Guru - Episode 51 - Should I code isolation for CDIFF? What about MDRO's?
Send us Fan MailWhen should isolation be coded? What are the constituents of an MDRO?
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47
The MDS Guru - Episode 50 - How to Validate Your Cognitive Responses on the MDS for Missouri Medicaid
Send us Fan MailCan I summarize? Is an impaired BIMS enough documentation to mark the resident impaired?www.renshawconsulting.com
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46
The MDS Guru - Episode 49 - The Discharge Mobility & Discharge Self-Score Scores
Send us Fan MailWhat questions in section GG are used here? Are these included in the 5-star rating?
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45
The MDS Guru - Episode 48 - When Should I Do A Significant Change?
Send us Fan MailDoes changing physicians prompt a sig change? My resident is leaving the facility after a major decline. Do I complete a sig change?
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44
The MDS Guru - Episode 47 - Data elements that cause the 2% APU deduction if DASHED
Send us Fan MailWhat? 13 pages on CMS.gov? We break this down to a very easy subset. SNF QRP FY2026 APU Table for Reporting Assessment Based Measures and Standardized Patient Assessment Data Elements If you would like to look for yourself,
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43
The MDS Guru - Episode 46 - What parts of the MDS figure into the Nursing CMI?
Send us Fan MailDoes walking figure into the nursing CMI? What about HIV or cancer? We briefly cover the entire MDS to reveal what sections play into this calculation. Tune in!
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42
The MDS Guru - Episode 45 - What primary medical condition category is this diagnosis?
Send us Fan MailIs schizophrenia non-traumatic brain dysfunction or medically complex? What category do I choose for this fall with a fracture and subsequent hip replacement?
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41
The MDS Guru Episode 44- How Do I Code This Tube Feeding in Section GG For Eating?
Send us Fan MailWait, my resident is NPO, how do I code eating? My other resident has never ate by mouth?
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40
The MDS Guru Episode 43 - The Draft Item Changes for the October 2025 MDS
Send us Fan MailAdding a section R? What does that mean? What will be in it?
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39
The MDS Guru - Episode 42 - Should I code this weight loss?
Send us Fan MailIs this weight loss coded on the last MDS real? Wait, my resident lost weight at 4 months but is back to normal. Do I code this?
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38
The MDS Guru - Episode 41 - When to code a UTI & Sepsis
Send us Fan MailThe most common erroneously coded QM is a UTI. Are you coding it wrongly too on the MDS? How did the RAI change the coding in relation to sepsis last October?
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37
The MDS Guru Episode 40 - A Missouri Medicaid Bombshell!
Send us Fan MailWe answer a few more of your questions and drop the new bombshell from Myers & Stauffer!!
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36
The MDS Guru Episode 39 - How to Write a Physician Query
Send us Fan MailWhat do we include? What should we never do? What is a leading query?www.renshawconsulting.com
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35
The MDS Guru Episode 38 - Hospice in LTC and MDS
Send us Fan MailWhat is our role as MDS in the LTC hospice program? What do we care plan for these residents?
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34
The MDS Guru Episode 37 - General Questions
Send us Fan MailA brief summary of our recent questions.
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33
The MDS Guru Episode 36 - Complete Details of a Missouri Medicaid Audit - The 411
Send us Fan MailI attended a Myers & Stauffer Missouri Medicaid Audit in its entirety. Helpful insight into what the auditors are looking for. Get the details here!
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32
The MDS Guru Episode 35 - The New Missouri Medicaid Cost Report Release
Send us Fan MailThere is a typo on everyone's report! How long will this rate be in effect? The work we are doing now goes toward a rate when? Is it too late to fix anything for January?
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31
The MDS Guru Episode 34 - Care plan & MDS timing
Send us Fan MailWhen do I update my care plan? How long do I have to complete admission assessments when the resident has been back to the hospital? Tune in now!
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The MDS Guru Episode 33 - What is an ADP for a SNF revalidation?
Send us Fan MailCMS now wants all SNF's to report all consultants, any company who leases SNF property, exercises operational or financial control, etc on their annual provider enrollment forms. WHY?
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The MDS Guru Episode 32 - How to claim respiratory therapy on the MDS
Send us Fan MailWhat interventions should we put into the orders? Should I care plan the breathing treatments? What is a respiratory nurse? Tune in for all the answers!
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The MDS Guru Episode 31 - QM General Questions
Send us Fan MailA few general QM questions, a mini Q & A. Tune in now!
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The MDS Guru Episode 30 - Missouri Medicaid Case Mix Q & A Part 3
Send us Fan MailShould the IDT meeting note for section GG be before the ARD?Is chronic lung disease the same as respiratory failure?
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