MDS Optimization

AI-Enabled MDS Verification & Optimization Driving ROI in Long-Term Care

healthcare, user research, ai/nlp model development, product design + development

overview

Digital Scientists created an MDS Real-Time Verify & Optimization platform, an AI-enabled solution that integrates directly with PointClickCare to support MDS coordinators in completing assessments more accurately and efficiently.

By combining real-time verification, AI-powered optimization, and user-centered design, the platform helps nurses reduce manual review, increase reimbursement accuracy, and improve Five-Star ratings — while ensuring compliance with federal and state regulations.

industries

Senior nursing facilities
Long-term care
Digital health

services

Product strategy
UX research & design
AI/NLP model development
EHR integration (PointClickCare)
Functional prototyping
Agile product development
MVP launch

the challenge

MDS coordinators are under intense pressure to complete assessments accurately and on time.

Every error, inconsistency, or missed opportunity can mean:

Lower reimbursement due to under-coding of conditions and NTAs
Reduced Five-Star ratings from quality measure inaccuracies
Increased audit and compliance risk from inconsistent coding or misalignment with complex federal and state regulations

For multi-facility operators, these issues scale quickly—impacting both financial performance and regulatory standing across dozens of facilities.

our approach

Building trust and user adoption through AI recommendations and data integrations.

We partnered with healthcare organizations to create an AI-enabled Real-Time MDS Verification & Optimization platform that integrates directly with PointClickCare (PCC).

Three priorities shaped the solution:

1. AI-Driven Accuracy & Optimization

Natural language processing (NLP) scans provider notes and progress reports in real time.
Flags errors and surfaces reimbursement opportunities (e.g., ARD shifts, ICD-10 code alignment, NTA capture).

2. Trust Through User Research

Conducted in-depth interviews and workflow shadowing with MDS nurses.
Designed with transparency: every AI recommendation is linked to supporting documentation.
Built confidence through explainability and manual override options.

3. Seamless PCC Integration

Pulls source documentation directly from PointClickCare.
Eliminates toggling between systems and reduces duplicate entry
Embeds into the daily workflow to maximize adoption.

data + systems

Industry Systems & Data Standards

CMS MDS & PDPM Guidelines
ICD-10 / NTA Coding
Five-Star Quality Measures
ARD Scheduling Standards
Survey & Audit Readiness

the solution

Transforming MDS with AI-Driven Accuracy

The platform provides:

EHR-native Verification dashboard: AI instantly validates MDS items, flagging inconsistencies before submission, directly from PointClickCare with no additional login or workflow disruption.
Evidence-based review: Nurses see exactly where documentation supports (or fails to support) coding.
Optimization engine: Highlights ARD scheduling and coding decisions that drive reimbursement and quality improvements.

roi + impact

Measurable Value from Day One

Early adopters are already seeing tangible benefits across operations, quality, and financial performance. By reducing manual effort, improving accuracy, and ensuring compliance, the platform delivers meaningful outcomes for both residents and facilities:

40–60% reduction in manual review time

per assessment — freeing nurses for direct resident care.

Improved Five-Star quality ratings

by reducing submission errors and aligning ADL/cognitive scores.

Reimbursement potential:

Correctly capturing NTAs and aligning ICD-10 codes translates to additional revenue per facility per quarter.

Fewer compliance risks:

Inconsistencies are flagged before submission, reducing costly re-work or audit risk.

Key Takeaways

The project demonstrates how AI-driven optimization delivers value across clinical, financial, and operational dimensions:

AI saves time: Nurses cut hours of manual chart review per assessment.
AI improves quality: More accurate submissions mean stronger Five-Star ratings.
AI drives revenue: Properly coded NTAs and ICD-10s unlock reimbursement dollars often left on the table.
Integration builds trust: Seamless PCC integration and transparent design ensure adoption at scale.

Capabilities

Industries