QAPI For Skilled Nursing

QAPI Basics for Skilled Nursing

Let’s start with the basics. Quality assurance has been around since the Omnibus Budget Reconciliation Act nursing home reforms. However, the Affordable Care Act of 2010 strongly emphasizes quality for all of healthcare. Then, the addition of performance improvement within skilled nursing became reality in 2016 with the final rule of Requirements of Participation.

Quality Assurance Performance Improvement (QAPI) is now the foundation to manage quality.

It is important to understand the foundation and expectations for the new QAPI requirement. Conversations with various providers underscores this.

So, let’s begin with an understanding of what each means:

  • Quality Assurance (QA): strategies seeking to prevent, detect, and correct problems in the quality of services delivered to residents
  • Performance Improvement (PI): strategies that attempt to improve quality through continuous study, modification and improvement of services provided

Continuous improvement is key

A key function of QAPI is that it is continuous. Quality is being defined by external and internal customers.

To remain competitive, you need to create a culture of quality improvement. That is, you want to continuously identify opportunities for improvement.

Teamwork makes it happen

When implementing QAPI, remember that this is a team effort. It is no longer confined to the “QAA Committee.”

Staff at all levels of your facility contribute – identifying the need or opportunity, coming up with proposed processes, testing such processes, and so on.

This extends beyond your internal stakeholders. Bring in perspectives from external stakeholders such as families, physicians, and consultants.

Do some light reading

You also need an understanding of developing and maintaining the QAPI process.

Knowing where and how to start can be confusing. To support your initiatives, the Centers for Medicare and Medicaid Services (CMS) has many resources that not only help with the QAPI plan but also help create the culture to support your quality initiatives. These can be found at the CMS web site here.

If you haven’t read through these online tools, I’d recommend doing so. For example, their self-assessment tool will help you evaluate and leverage existing processes.

Now that you have the basics, check out my other blogs on QAPI:
Ready for QAPI?
8 Questions on Using Data in QAPI

Denise Wassenaar

Denise Wassenaar joined MatrixCare as Chief Clinical Officer in May 2013. A recognized leader in long-term care, Wassenaar brings innovative strategies and solutions to the changing environment of the post-acute provider. She has more than 20 years in the post-acute settings serving as Vice President of Clinical Services for a CCRC organization, President of Alliance Pharmacy Services and other executive positions. Wassenaar holds BS and MS Degrees in Nursing from Purdue University and is a licensed nursing home administrator. She serves on the Board of Directors of a CCRC in Arizona.