Take credit where credit's due on the MDS. If a resident's pain management regimen controls his pain, give your facility a good grade on the MDS.
Record a zero for no pain at J2a (frequency of pain) when residents report they have been pain free during the seven-day lookback thanks to their pain management regimen.
Coding what you think the patient's pain would be without treatment will artificially increase pain quality measures - and that may give surveyors the idea the facility isn't addressing this vital clinical issue.
Tip: Even though a resident doesn't have enough discomfort to trigger the pain QM, make sure the facility is meeting his goals for pain relief.