Nursing homes have long been required by federal regulations to create a Quality Assessment and Assurance (QAA) committee, which serve to periodically review and correct detected shortcomings in the delivered care. These meetings often result in action plans that focus more on changes to reduce the number of shortcomings, rather than analyzing the impact of changes on quality of care or how the achieved quality of care could be sustained. When the Affordable Care Act was enacted in 2010, the Centers for Medicare and Medicaid Services (CMS) combined QAA with a more proactive program called Quality Assurance Performance Improvement (QAPI).
The QAPI requires nursing homes to establish and sustain accountability, providing both quality of care and quality of life opportunities for the residents. QAPI significantly expands the scope of the regulation, and challenges each nursing home to go beyond compliance to address deficiencies and focus on system correction for shortcomings. Nursing homes are now required to incorporate a formalized process, including five key elements and twelve action steps that act as the basic building blocks, into an effective QAPI program.
While QAA required nursing homes to identify and correct quality risks, QAPI shifts the focus to facility-wide involvement in data-driven continuous improvement activities. QAPI programs require a comprehensive, formalized plan and engaged leadership and greater involvement of all staff. CMS provided a preview of an online QAPI resource called “QAPI at a Glance” to help nursing homes build the foundation of their program. Each nursing home needs to submit a QAPI plan to CMS within a year of the regulation change announcement using these resources and tools. This could require organizational changes and creating new infrastructures, policies and procedures.
This new program focuses on a best practice system improvement more than individual regulatory compliance. Nursing homes will need various strategies to evaluate and implement their procedures to fit QAPI action steps into the organizations’ mission, vision and guiding principles. The AssuredPartners NL CORE Solutions and senior living professionals will work with you to make sure that your organization is on the right track with your QAPI plan. Our team of clinical risk management consultants is equipped to assist your organization throughout the transition. To learn more or to contact an agent, visit: Clinical Risk Management.
Resources: CMS QAPI Guide: What You Need to Know, CMS QAPI Module Operations GuideShare This: