Nimbus Systems
Your MDS is costing you money.
We find the revenue your clinical documentation is leaving on the table and monitor your entire portfolio so you don't get blindsided by CMS.
The Problem
Most facilities underdocument. The revenue disappears quietly.
Missed diagnoses, uncoded NTA conditions, skipped IPAs. Each one is revenue that Medicare would have paid if it had been documented correctly. For most operators, the gap is invisible until someone shows them.
PDPM Revenue Recovery
We read your clinical documentation, compare it against what was coded on the MDS, and show you exactly how much revenue you're losing. Facility by facility, with the dollar value attached to each gap.
- Diagnosis gap detection against physician notes
- NTA scoring validation across medications and treatments
- IPA trigger identification for qualifying condition changes
- Section GG calibration against therapy documentation
- PDPM classification validation against CMS grouper logic
Portfolio Intelligence
Ongoing monitoring across your entire portfolio. Star ratings, survey readiness, acquisition diligence, five-star recovery, workforce benchmarking, and competitive landscape. So you're never caught off guard by CMS.
40–60%
of IPA triggers go unassessed, each one worth $3,000–$5,500 in additional Medicare revenue. That's the kind of money that disappears when documentation gaps go unchecked.
Case Study
48-Facility Portfolio Analysis
We analyzed a multi-state skilled nursing operator using publicly available CMS data to quantify PDPM revenue gaps.
Methodology
Using four CMS public datasets (Provider Information, MDS Quality Measures, SNF Value-Based Purchasing scores, and PDPM rate tables), we compared each facility's nursing case-mix index against the 75th percentile benchmark for its state. Facilities below benchmark are underclassifying residents, resulting in lower per-diem Medicare reimbursement.
Portfolio average CMI of 1.407 exceeds both Texas (1.303) and Louisiana (1.288) state averages. Strong documentation overall, but 19 facilities still fall below the 75th percentile.
The top 10 gap facilities account for $5.1M of the $5.9M total opportunity. Three 1-star facilities showed CMIs more than 0.25 below benchmark. That's systematic underclassification, not marginal coding differences.
97% of facilities had VBP multipliers below 1.0, compounding the PDPM revenue loss with reduced value-based payments.
This analysis uses only the nursing CMI, one of five PDPM payment components. A full audit typically uncovers 2–3× the revenue identified here.
| Facility | Rating | CMI | Benchmark | Gap | Est. Annual Gap |
|---|---|---|---|---|---|
| Facility A | 1.100 | 1.371 | 0.271 | $714K | |
| Facility B | 1.111 | 1.371 | 0.260 | $705K | |
| Facility C | 1.104 | 1.371 | 0.268 | $676K | |
| Facility D | 1.203 | 1.371 | 0.168 | $476K | |
| Facility E | 1.150 | 1.371 | 0.221 | $470K |
Analysis based on CMS Provider Data Catalog, MDS Quality Measures, and SNF VBP FY2026 Facility-Level Dataset. No protected health information was used.
No Risk to Start
How It Starts
Free Portfolio Preview
We pull your public CMS data and show you what your facilities look like across star ratings, deficiencies, staffing, and quality measures. No cost, no commitment.
Prove the Revenue Gap
If you see value, we run a full PDPM audit on one facility to show you exactly how much documentation is leaving on the table.
You Decide
No pressure, no long-term contracts until you've seen results. You move forward when you're ready.
Who We Are
Built for Operators, Not by a Vendor
Nimbus Systems was founded by Josh Guth to solve a problem he saw firsthand: skilled nursing operators making million-dollar decisions with incomplete data. We dig into your facilities' data to produce intelligence that's specific to your buildings — not generic industry benchmarks.
Based in Louisiana. Working with multi-state operators across the South and Midwest.
Pricing
Transparent Engagement Models
Portfolio Intelligence
- Monthly facility monitoring
- Quality measure tracking
- Competitive intelligence
- Quarterly executive reviews
PDPM Revenue Audit
- Full 5-component PDPM analysis
- Diagnosis gap detection
- Section GG calibration review
- IPA trigger identification
Typical ROI: 10–50× what you pay us. We find the money; you keep it.