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Educating & Connecting

  • Interface with community leaders and clients serving as content experts for reimbursement and revenue management of Medicare PDPM, Managed Care Organizations, and Medicaid.

  • Work directly with MDS Coordinators to enhance knowledge and skills to improve clinical outcomes, compliance, quality reporting, and correct coding

  • Provide education and auditing of reimbursement policies and procedures, including documentation, compliance, and operations

  • Providing custom data informatics intelligence to your existing nursing and rehab EMR. 

  • Direct staff education and support for improved clinical outcomes, quality reporting, and accurate coding as outlined by the Resident Assessment Instrument (RAI).

Businessman Working in Office
Working in Office


  • Patient-Driven Payment Model (PDPM) and Case-mix Index (CMI) performance review and strategies for improved compliance and revenue

  • Assist in developing an effective Resident Assessment Instrument (RAI) process

  • Managed Care and 3rd party contract reimbursement,5 Star, QAPI and Quality Measures (QMs)

  • Provide on-site support services, consultation, and recommendations for communities and clients, as requested

  • Consistent analysis of Case-mix Index (CMI) to efficiently manage patient costs, Five-Star, QAPI, and Quality Measures (QMs)


  • Consult clients regarding compliance with policies and procedures as it relates to reimbursement systems to ensure compliance with managed care organizations (MCOs), federal and state programs

  • Conduct audits at communities to assure standards, policies and procedures are being followed

  • ​Remain informed regarding regulatory changes and consult in developing and implementing procedures for communities and clients to remain in compliance

  • Ensure client policies and procedures maximize resident outcomes, and reimbursement and maintains regulatory compliance for all state and federal programming

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