CClearShiftRun a free audit
Scope

The standards behind every gap, and what ClearShift cannot do

Every gap the audit reports names a rule. This page names all of the rules in one place, shows which required element comes from which one, and states the limits plainly. If a claim on this page is wrong, tell us and we will correct it.

Updated September 13, 2026·General CMS HCBS floor, Ohio rules named
01

The three standards

Twelve required elements, three federal sources. The audit carries no other rule set by default.

Provider recordkeeping
42 CFR 431.107(b)
A provider that bills Medicaid must keep records that fully disclose the extent of the services it furnished. This is the rule behind the identifier, the service date, the response of the person served, the caregiver credential and the signature.
Person-centered service plan
42 CFR 441.301(c)
Services must be delivered as set out in the person-centered service plan. This is the rule behind the type of service, the plan dates, the staff ratio, the narrative tied to a plan goal, and the supervisor co-signature where a state requires one.
Electronic visit verification
21st Century Cures Act sec. 12006
EVV must capture the date, the location, the person served, the caregiver, and the exact time service begins and ends. This is the rule behind exact start and stop times and behind service location.
02

Which element comes from which rule

The same twelve elements the audit checks, in their canonical order. A blocker missing outright makes the note not billable. A gap is an element a payer can deny on. An element that is in the note but too thin to support the claim is reported as thin, whichever severity it carries.

How that becomes the three labels

A blocker that is absent reads “Not billable”. Any other absent element reads “Missing”. An element present but insufficient reads “Too thin”, blocker or not, because a thin service date is a different problem from no service date. The audit lists gaps worst first, not in the order below.

Name and Medicaid ID of the person served
Blocker
full name as billed plus the Medicaid ID of the person served
42 CFR 431.107(b) — provider records must fully disclose the extent of the services furnished.
Service date
Blocker
the calendar date the service was delivered, MM/DD/YYYY
42 CFR 431.107(b) — provider records must fully disclose the extent of the services furnished.
Exact start and stop times
Blocker
clock-in and clock-out to the minute, both present, with any break in the shift explained and a statement that EVV was recorded where it is required
21st Century Cures Act sec. 12006 — EVV must capture the date, location, the person served, the caregiver, and the exact time service begins and ends.
Service location
Gap
where the service was delivered — home, community, group setting or facility
21st Century Cures Act sec. 12006 — EVV must capture the date, location, the person served, the caregiver, and the exact time service begins and ends.
Type of service delivered
Blocker
the service named the way the service plan names it — homemaker/personal care, adult day support, community respite
42 CFR 441.301(c) — services must be delivered as set out in the person-centered service plan.
Service plan dates
Gap
the effective dates of the ISP or person-centered service plan the service was authorized under
42 CFR 441.301(c) — services must be delivered as set out in the person-centered service plan.
Staff-to-individual ratio
Gap
the ratio actually delivered during the shift — 1:1, 1:2, 1:3
42 CFR 441.301(c) — services must be delivered as set out in the person-centered service plan.
Tasks performed, tied to the service plan
Blocker
a specific narrative of what was done, linked to a named goal or outcome in the ISP or service plan
42 CFR 441.301(c) — services must be delivered as set out in the person-centered service plan.
How the person served responded
Gap
an objective observation of participation, response or change in condition
42 CFR 431.107(b) — provider records must fully disclose the extent of the services furnished.
Caregiver full name and credential
Gap
the caregiver's full name plus role or credential, such as DSP, PCA or LPN
42 CFR 431.107(b) — provider records must fully disclose the extent of the services furnished.
Caregiver signature attesting the record is true and accurate
Blocker
a signature or electronic attestation that the documentation is true and accurate, initials where the county form takes them
42 CFR 431.107(b) — provider records must fully disclose the extent of the services furnished.
Supervisor co-signature, where required
Gap · conditional
a licensed supervisor's co-signature, where the state or service type requires one
42 CFR 441.301(c) — services must be delivered as set out in the person-centered service plan.
03

How the audit actually works

1

The rules are fixed in code

The twelve elements, their citations and their severity are written in our source, not produced by a model. A model decides one thing only: whether an element is satisfied, thin, or absent. It never invents a requirement and never writes a citation.

2

One reading, no randomness added

The note is read once at temperature zero, so the same note returns the same list. The sample note and the published example audit never reach a model at all — their results are frozen, so a demo you show a colleague looks the way it looked for you.

3

Three verdicts, never a score

Missing a blocker: not billable. Weak but no blocker missing: thin. Every element satisfied: billing-ready as written. There is no percentage, no grade and no confidence number, because a payer does not use one.

4

Corrections go into the rule set

In September 2026 a county board provider liaison told us we audited the note for two things that belong on the claim. She also named two elements we had missed. We changed the rule set, the checklist and the guides that week.

04

What ClearShift does not do

Eight limits. We would rather you read them before you rely on the audit than after.

It does not decide what a payer pays
ClearShift reports what a required element is missing. A note with zero gaps can still be denied for eligibility, authorized units, a filing deadline or a coding error. We never describe a note as approved, certified or compliant — only billing-ready as written.
It does not see your EVV, claims or billing system
The audit reads one text note and nothing else. It cannot compare a stop time to an EVV record, cannot check units against an authorization, and cannot tell you whether two services overlap on the same day. It can only tell you the note fails to state something a payer will look for.
It does not know every state requirement
The default check is the general CMS HCBS floor. Your state waiver manual adds requirements on top of it. Ohio rules are the ones we know best, from OAC 5123-9-30, 5123-9-39, 5123-9-06 and the EVV rules in OAC 5160-32. Other states will have additions ClearShift does not yet carry.
It does not check the identity of the person served
The paste box asks you to remove the name and Medicaid ID before pasting, so ClearShift cannot see them. That element is reported as not checked, never as satisfied and never as a gap. You still have to confirm it yourself on the real record.
It cannot know whether the shift happened as written
The audit reads a document. It has no way to tell a complete note from a fabricated one, and it is not a fraud check. A note can be fully billing-ready and still be wrong about the shift.
It is not legal, billing or compliance advice
Every gap names the rule behind it so you can read the rule yourself. Where a requirement turns on your state, your service type or your provider agreement, the waiver manual and your county board are the authority, not us.
It does not submit claims or touch your billing
ClearShift prepares notes. Nothing leaves it toward a payer, a clearinghouse or a state system.
The paid workspace is not built yet
ClearShift Compliance at $99 is a batch audit run by hand today: you email a day of notes and they come back with the gaps named, within one business day. Saved history, multi-user access and the audit trail are what the price funds next, and we will not describe them as live until they are.
05

Who runs ClearShift

Why the address says nanocorp

ClearShift is a small independent product. It is built and hosted on NanoCorp, which is why the site sits at clearshift.nanocorp.app and why payment happens on checkout.nanocorp.so. Same product, our host’s domains. If you were expecting a clearshift.com and want to confirm you are in the right place, reply to any email we sent you, or write to clearshift@nanocorp.app and a person answers.

Email is the whole support channel: clearshift@nanocorp.app. Send a note and we will audit it by hand. Tell us a rule we have wrong and we will fix the rule set and say so on this page. What we do with a note you send is on the note and email handling page.

Sources
  • 42 CFR 431.107(b) — required provider agreement and recordkeeping.
  • 42 CFR 441.301(c) — person-centered service plan requirements for 1915(c) waivers.
  • 21st Century Cures Act sec. 12006 — electronic visit verification data elements.
  • OAC 5123-9-30, 5123-9-39, 5123-9-06 — Ohio DODD homemaker/personal care, waiver nursing, and administrative documentation rules.
  • OAC 5160-32 — Ohio Medicaid electronic visit verification program.

Now check one of your own notes

Paste one shift note into the audit on the homepage. Every gap it reports names one of the rules above. Remove the person's name and Medicaid ID first.

Run a free audit

Not ready to paste anything? Read a full audit of one real note — every gap, with the standard behind it.