Episode #34
The MDS Mistakes That Could Be Costing Your Facility with Loraine Leija
MDS mistakes don't just create paperwork problems—they can impact reimbursement, quality measures, audits, care planning, and the story your facility tells about each resident. In this episode of Our Purpose – The LTC Podcast, Kip Kruger, James Dieter, and Chris Light sit down with Loraine Leija, Vice President of Clinical Reimbursement and Ancillary Services at Creative Solutions in Healthcare, to break down MDS, PDPM, documentation, and clinical reimbursement. Loraine discusses common PDPM misconceptions, why facilities need to continually monitor changes in resident condition, and how documentation gaps can create missed reimbursement opportunities. She also explains how MDS data connects to quality outcomes and resident care. The conversation explores the growing role of AI in clinical documentation, MDS audits and validation, interdisciplinary communication, and why successful MDS coordinators need the entire IDT working together. For MDS coordinators, DONs, administrators, reimbursement professionals, and long-term care leaders, this episode is a practical look at how better documentation, stronger communication, and accurate assessments can lead to better outcomes.
