Q&A: I am being pressured to lie on the MDS. What actions can I take?

Posted By: Judy W. Brandt, RN, BA, QCP, CPC, RAC-MT, DNS-CT
Post Date: 02/12/2018

Question: I am being pressured to lie on the MDS. To be clear, not outright lie about therapy minutes or skilled services, but to hide falls, pain, and UTIs to keep the Quality Measures up.  I refused to do this. What actions can I take?

Answer: You can report anonymously to your compliance committee. They are required to have a hotline number. You can report to your chain of command. If the chain of command is the issue, you can report to the highest levels above your chain. If all of that is also part of the problem, I would retain an attorney and seek counsel. You cannot lie on the MDS.  As a last resort, you can call in a complaint to your state agency or 1-800- Medicare. Tell them you are reporting fraud, no waiting.

My opinion is that you should talk with the person first. Look at the manual, specifically the Attestation statement. Tell the person, “I must follow these rules. It feels like you are suggesting that I lie."  Sometimes that snaps him/her out of it.

My final thought is that you cannot lie. You are personally and criminally responsible if you know you are lying and do it anyways.

Reviewed 12/5/19

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