Healthcare Audits: How HAP Supports Clients Through MDS Validation
As the federal government concludes the latest shutdown, skilled nursing providers are once again bracing for MDS validation audits. These are a detailed review of records, coding, and documentation designed to verify that submitted data accurately reflects resident care. These healthcare audits will influence both compliance and reimbursement outcomes, making preparation essential for every organization.
At Health Advisory Partners (HAP), our role is to ensure you’re ready. We help clients proactively validate their MDS data, confirm HIPPS code accuracy, and review audit records before submission so that when the audit begins, there are no surprises.
What the SNF Validation Program Means for You
The Skilled Nursing Facility Validation Program is designed to verify the accuracy of data used for quality reporting and value-based payment calculations. In practice, this means that any SNF submitting MDS assessments may be randomly selected for a valuation audit. The CMS contractor, Healthcare Management Solutions, LLC (HMS), will request medical records directly from selected facilities to confirm that MDS data, including HIPPS codes, accurately matches the clinical record.
The purpose is simple: to ensure that reported measures reflect true clinical performance. But the process itself can be complex, time-consuming, and costly if errors are found. That’s why it’s critical to have a partner who not only understands MDS and quality data but can help you strengthen your systems before your documentation is ever requested.
HAP’s Approach to Healthcare Audits
At Health Advisory Partners, we go beyond standard compliance checks. Our team of clinical experts and certified quality consultants trains organizations’ teams and helps them develop robust systems that meet CMS requirements.
Our Quality and MDS services are built around three key goals:
Ensuring accuracy and consistency in MDS reporting
Supporting staff with expert guidance and analysis
Strengthening internal processes to withstand external review
When it comes to validation audits, these principles guide every step of our support.
Proactive Healthcare Audit Assistance
Our MDS support goes beyond standard training by helping facilities stay compliant with electronic medical record (EMR) monitoring and data validation. Through this process, HAP consultants work with your team to ensure that coding and documentation align and help facilitate follow up.
By proactively reviewing MDS assessments, we help confirm that HIPPS codes are validated and supported by the medical record prior to any external audit. This proactive approach helps:
Identify discrepancies before CMS or its contractors do
Safeguard appropriate reimbursement
Strengthen confidence in your facility’s documentation integrity
Rather than reacting to an audit, we help you build a process where every record stands on its own—accurate, complete, and ready for review.
Review and Readiness: Preparing the Audit Record
When a validation audit begins, CMS requests resident records which include documentation supporting MDS data and HIPPS codes, therapy notes, physician orders, SNF certs, etc. Missing or incomplete materials can quickly result in findings or corrective action.
HAP assists clients by reviewing audit records before submission to ensure all necessary components are present and properly organized. Our team examines each document for consistency, accuracy, and compliance with CMS standards, confirming that the data being submitted truly represents the care delivered.
This attention to detail ensures that providers enter the validation process with confidence. Every page tells the same story, and every HIPPS code is backed by clear, complete documentation.
Strengthening Quality from the Inside Out
Preparing for validation audits isn’t just about checking boxes; it’s about building a stronger foundation for quality. HAP’s Quality Consulting Services provide the framework for sustained improvement that extends far beyond audit readiness.
We help you identify opportunities to enhance performance at every level. Whether it’s MDS assessment analysis and support or clinical program development, we help you identify opportunities to enhance performance at every level. Our team can assess your current systems on-site or remotely, then recommend improvements designed to raise the overall level of excellence in ways that will be noticed by external auditors and by your residents and their families.
The result is a more efficient, compliant, and high-performing organization that’s ready for any level of review.
Turning Compliance Into Confidence
At Health Advisory Partners, we believe audit preparation should do more than prevent penalties; it should build confidence. By approaching validation audits proactively, providers gain deeper insight into their own data, uncover process gaps before they become problems, and ensure that every measure reported to CMS reflects the quality of care actually delivered.
We help clients see validation not as a burden, but as an opportunity to:
Reinforce best practices across the clinical team
Strengthen medical review submission process
Improve accuracy in MDS data used for reimbursement
Enhance organizational credibility with regulators and residents alike
When your systems are built for accuracy and consistency, compliance follows naturally.
CMS Audits: Preparing for What’s Next
With the shutdown nearing an end and CMS audit programs resuming, now is the time for skilled nursing providers to review their processes and get ahead of upcoming requirements. The SNF Validation Program is expected to grow in scope and intensity as CMS continues to refine quality reporting and payment systems.
Facilities that prepare early by validating data, strengthening documentation, and partnering with experienced consultants will be better positioned to succeed under the new audit framework.
HAP can help you take the right steps now:
Conduct a pre-validation MDS review to confirm accuracy and HIPPS code alignment
Complete an audit record readiness assessment to ensure all required documentation is in place
Evaluate quality assurance systems to identify improvement opportunities before CMS review begins
Our consultants bring decades of combined experience in post-acute quality programs, compliance, and operational excellence. Whether you need short-term guidance or a long-term partnership, HAP provides the structure, tools, and expertise to keep your organization prepared and performing at its best.
Partner with HAP for Complete Validation Support
Healthcare audit processes are complex, but it doesn’t have to be overwhelming. With Health Advisory Partners at your side, your facility gains a proactive partner dedicated to accuracy, quality, and continuous improvement.
Our consultants will help you validate MDS data before it’s reviewed, confirm HIPPS codes before they’re challenged, and ensure your audit records are complete before they’re submitted. More importantly, we’ll help you build sustainable quality systems that keep your organization compliant and confident well beyond the audit cycle.
Want help with your MDS audit? Contact us today.
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