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Nursing Homes: CMS Conducting Quality Improvement Research

Published On: Jun 22, 2012

The Centers for Medicare and Medicaid Services (CMS) is giving nursing home providers the opportunity to participate in a bold, new quality improvement initiative mandated through the Affordable Care Act. 

The Affordable Care Act requires CMS to establish standards relating to Quality Assurance and Performance Improvement (QAPI) and provide technical assistance (TA) to facilities on the development of best practices for QAPI. 

QAPI initiatives

The following are the CMS QAPI initiatives:

  • Five Elements:  CMS has identified the following key concepts that are found throughout effective quality systems and are the framework for establishing a QAPI program:  Design and Scope; Governance and Leadership; Feedback, Data Systems, and Monitoring; Performance Improvement Projects; and Systematic Analysis and Systemic Action.

  • QAPI Tools and Resources:  CMS, in collaboration with their contractors, University of Minnesota and subcontractor Stratis Health, are continuing to identify and design effective QAPI tools and resources specifically for nursing homes.
  • Technical Assistance:  CMS contractors are testing QAPI tools, resources, and approaches to providing TA in a multi-year demonstration project with a small group of nursing homes. These materials will be made available to all nursing homes following testing.

  • The Nursing Home Quality Improvement Questionnaire:  In another collaborative effort, CMS' contractor, Abt Associates, Inc., and their subcontractor, the Colorado Foundation for Medical Care, designed a questionnaire to identify the quality systems and processes nursing homes currently have in place, as well as assess the extent to which these systems and processes function to help nursing homes recognize and address quality issues. This information will help CMS and our contractors refine the QAPI components.

The Nursing Home Quality Improvement Questionnaire will be administered to a representative sample of 4,200 randomly selected nursing homes in 2 waves: 

  • Summer 2012: First wave of data collection
    • Objective: Establish a baseline of QAPI practices in nursing homes and gather information on the challenges and barriers to implementing effective QAPI programs
  • 2013-2014: Second wave of data collection
    • Objective: Assess the development of QAPI systems, determine what types of TA to make available to nursing homes in the future, and determine the potential impact of TA in advancing QAPI in nursing homes

Nursing home providers participating in the data collection effort will be given the option of completing an electronic questionnaire available via the internet or a hard copy questionnaire mailed directly to their facility. 

The questionnaire will take approximately 20 minutes  to complete. Nursing homes participating in the data collection will not be identified  by name or any other identifying information.   

Your participation in this survey effort is crucial to the goals of CMS in aligning QAPI Technical Assistance with provider needs. 

Check your Quality Improvement & Evaluation System (QIES) mailbox for notification that you have been selected to participate in this important information gathering.

Supporting organizations

CMS is being supported in this effort through partnership with the following organizations: 

  • American College of Health Care Administrators.
  • American Health Care Association.
  • LeadingAge.
  • Advancing Excellence in America's Nursing Homes.
  • American Medical Director's Association.
  • National Association of Directors of Nursing Administration in Long Term Care.

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