Resident Assessment

F641 — Accuracy of Assessments

Failure to ensure each MDS assessment accurately reflects the resident's status. Common when documentation in the medical record contradicts coded MDS items — frequently audited by CMS for fraud and Medicare Advantage downcoding.

Reg cite · 42 CFR 483.20(g) 99 surveys in corpus 26 states

What surveyors look for

  1. MDS coding traceable to source documentation (nurses' notes, therapy notes, MAR, TAR)
  2. Section GG mobility/self-care scores match physical/occupational therapy evaluation
  3. Section K nutrition data matches dietary intake records
  4. Section O therapy minutes match the actual therapy logs minute-for-minute

Common gotchas

  1. ADL scoring inflated to drive higher RUG/PDPM payment
  2. Therapy minutes coded without therapist signature on individual session logs
  3. Active diagnoses listed without physician confirmation in past 7 days
  4. Bowel/bladder incontinence under-coded to avoid Triple-Check audit

Real survey examples

From CMS-published 2567s in our corpus. Resident identifiers redacted.

AK SEV D 2024-12-12
Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure each resident receives an accurate assessment. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** . Based on record review, interview and observation, the facility failed to ensure the MDS (Minimum Data Set - a federally required assessment for long term care residents) accurately represented two residents (#37 and #97) out of 22 sampled residents. This failed practice placed the residents at risk for inadequate care planning and services to achieve their highest practicable and funct…
AK SEV D 2024-12-12
Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few request form is required to sign the assessment certifying the accuracy of that portion of the assessment .The information captured on the assessment reflects the status of the resident during the observation [look-back] period for that assessment. . 40 8 025025 [date] Department of Health & Human Services Centers for Medicare & Medicaid Services Printed: Form Approved OMB No. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NU…
AR SEV D 2025-01-24
Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure each resident receives an accurate assessment. Based on observation, interviews, record review, and facility document review, it was determined that the facility failed to ensure a comprehensive assessment accurately reflected a resident ' s status and needs for 1 (Resident) of 1 sample mix residents reviewed for comprehensive care plan development. The findings are: During an observation on [date] at 11:56 AM, this surveyor observed Resident with an oxygen concentrator in the room running at five (5) lit…
AR SEV D 2025-01-24
Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Resident was inaccurate as it did not document the resident had a bi-pap. During an interview with the MDS Coordinator on [date], she confirmed the Medicare 5-day MDS did not note the resident had a bi-pap. 15 2 045138 [date] Department of Health & Human Services Centers for Medicare & Medicaid Services Printed: Form Approved OMB No. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION (X3) DATE S…
AR SEV D 2025-05-06
Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure each resident receives an accurate assessment. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review, and facility policy review, the facility failed to ensure the Minimum Data Set (MDS) assessment was accurately completed for 2 (Residents #25, #184) of 3 residents reviewed for MDS accuracy. Specifically, the facility failed to identify and ensure information regarding bedrails was accurately assessed and completed on the MDS for Resident; …

Accepted POC examples

VA 2022-08-11
Multiple Construction: Name of Facility Surveyed: Facility Address (Street, City, State. Zip Code) Name of Accrediting Organization Performing Survey (if applicable): ID Prefix Tag SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency should be preceded by full regulatory or LSC identifying information) ID Prefix Tag 12 12VAC5-371-140(E) (3) (B). Criminal Record Checks: Sworn Disclosure and Reference Checks. Please cross reference to F607. 12 VAC 5-371-250 (A) & (D) & (E) Accuracy of Records Please cross reference to F641 [phone]-08-11 HARBOR'S EDGE VA F 001 F Multiple Construction: …

Related F-tags

F636 F656 F689

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