For Skilled Nursing Facilities

27 documentation checks that decide a SNF audit.

From PDPM rate integrity to ADRs, Medicare Advantage denials, and OIG utilization review — the same documentation decides whether a day is paid or recouped. This is the checklist our team runs before a reviewer does.

Built for MDS coordinators, DONs, and compliance leads

Covers PDPM, ADR defense, MA downcoding, and OIG exposure

Run it on your next assessment cycle — no call required

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$28.83B

in improper Medicare fee-for-service payments in FY2025. Under PDPM, your MDS is the record that decides which side of that number your facility lands on.

ADRs & documentation requests

Medicare Advantage audits & denials

OIG utilization review

PDPM rate integrity

Inside the checklist

27 checks, across the three domains that decide a SNF audit.

MDS & PDPM accuracy

Section GG function scoring, the NTA comorbidity tally, and the primary diagnosis that sets the clinical category — the items that set your rate and draw the first look.

ADR & medical-necessity defense

The corroborating documentation a RAC, UPIC, or MAC reviewer expects to find behind each paid day — mapped to the record before the request arrives.

Medicare Advantage & OIG exposure

The downcoding, utilization-review, and pattern triggers that move a single denial into an extrapolated finding — and how to close them upstream.

Why Precisian

“We built the 27-point audit to ask the questions a reviewer will — before they do. It’s the same diagnostic we run on day one of every nursing-facility engagement.”

Beyond the checklist

Facing an active ADR, a MA denial, or an extrapolated finding?

When the review is already underway, a checklist isn’t enough. Book a confidential case evaluation and we’ll tell you what’s defensible — and what we’d do about it.

Book a case evaluation