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CMS Launches New MDS Audits for SNFs

The Centers for Medicare & Medicaid Services (CMS) will be initiating new Minimum Data Set (MDS) audits through iQIES. Understanding the Skilled Nursing Facility (SNF) Validation Program and its requirements is key to avoiding compliance pitfalls and ensuring your documentation is audit-ready. Want to stay ahead of the curve? Blue & Co. offers pre-audit reviews to assess your readiness and catch potential issues before they become problems.

The Skilled Nursing Facility (SNF) Validation Program FAQs document from CMS provides detailed guidance on the SNF Validation Program, which is designed to assess the accuracy of MDS-based quality measures used in SNF Value-Based Purchasing (VBP) and Quality Reporting Programs (QRPs). Here’s a summary of the key points:

Overview of the SNF Validation Program

The program is an audit-based initiative to ensure data accuracy in SNF-reported quality measures.

It supports compliance and data integrity for SNFs participating in VBP and QRP.

Eligibility and Selection

All SNFs participating in Medicare may be selected.

Selection is randomized, and facilities are notified via their iQIES Provider folder.

Audit Timeline

Audits began in 2025.

SNFs are informed of selection and must respond within a specified timeframe to remain compliant.

Points of Contact (POCs)

SNFs must designate POCs to manage audit communications.

POC information must be kept up to date in iQIES.

Audit Requirements

SNFs must submit medical chart documentation for selected residents.

Documentation must follow specific formatting and naming conventions.

The submission must cover a defined timeframe relevant to the audit.

Submission Process

Documents are submitted via the iQIES system.

CMS provides detailed instructions on how to prepare and format files.

Stay Proactive, Stay Compliant

With CMS ramping up MDS audits through iQIES, preparation is more critical than ever. Understanding the SNF Validation Program and its requirements is key to avoiding compliance pitfalls and ensuring your documentation is audit-ready. Whether you’ve already received a notification or want to get ahead with a pre-audit review, our team is here to support you every step of the way. Don’t wait until the clock is ticking — reach out today and let us help you navigate the audit process with confidence.

Landon Hackett, CPA, MSA, Director

Stephanie Fitzgerald, RN, RAC-CTA, Manager

Liz Barlow, RN, CRRN, RAC-CT, DNS-CT, QC, Senior Consultant

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