How does the role of an MDS Coordinator relate to patient care and Medicare or Medicaid fraud?
A nursing home MDS Coordinator assesses the capabilities of a patient and creates individual care plans—including the level of treatment that must be delivered. A person in this position may be doing their job right but then fall under the pressure from the nursing home to up the ante for more billings or risk losing a well-paying job. It starts out with a fudged physical therapy session here or there. Then the message flows downhill to CNAs and other healthcare staff resulting in more falsified records. This escalates with more and more demands from above to get additional services—and higher value services—added to the bills. In the end, the Government is defrauded.