If you work in long-term care, you've probably heard the acronym QAPI, or Quality Assurance and Performance Improvement. Part of the Affordable Care Act (ACA) requires that all skilled nursing centers develop QAPI programs. The QAPI requirements were included in the Centers for Medicare and Medicaid Services’ (CMS) revised Requirements of Participation (RoP) for nursing centers, published in October 2016.
QAPI is the merger of two complementary approaches to quality management: Quality Assurance (QA) and Performance Improvement (PI). QA and PI combine to form QAPI, a comprehensive approach to ensuring high quality care.
The stated intention of the QAPI regulations is to “develop, implement, and maintain an effective comprehensive, data-driven QAPI program that focuses on systems of care, outcomes of care, and quality of life.”
QAPI will take many nursing homes into a new realm in quality—a systematic, comprehensive, data-driven, proactive approach to performance management and improvement.
The QAPI rule requires that all nursing homes establish and implement effective, comprehensive, data-driven QAPI programs that focus on systems of care, including indicators of outcomes of care, quality of life, and resident and staff satisfaction.
The QAPI requirements are being enforced over three phases: Phase I in November 2016, Phase II in November 2017, and Phase III in November 2019. Most of the requirements for the QAPI program will be implemented in Phase III. However, centers must develop a QAPI Plan by November 2017 and submit it to the Survey Agency at their first annual recertification survey.
If you need help and belong to the American Health Care Association, AHCA has free tools, resources, webinars, and programs to assist members in developing an effective and comprehensive QAPI program in their centers.
CMS also provides a set of tools and resources designed to help nursing homes begin implementing the foundations of QAPI. The full list of tools and resources are available by clicking here. Among them are QAPI at a Glance, a detailed guide that will enable nursing homes to understand QAPI principles and begin to incorporate these principles into their systems of care, and Hospital Engagement Network 2.0 Resources from the Health Research & Educational Trust.
An effective nursing home QAPI program can transform the lives of nursing homes residents through continuous attention to quality of care and quality of life.
Throughout the planning and development of QAPI for nursing home providers, CMS became aware that in order to facilitate a true paradigm shift in the country’s nursing homes, it would be necessary to include tools and resources for nursing home surveyors and consumers.
They did not stop at just issuing the quality measures. In addition to the QAPI regulations, CMS and other industry groups have developed training sessions that will help surveyors better identify when negative outcomes are symptoms of underlying systems failures. These resources are meant to empower and engage nursing home residents, their families, and advocates.
Once QAPI is launched and sustained, many facilities are reporting the rewards of QAPI to include:
If you work in a long-term care facility, how smoothly is the QAPI plan implementation going? What obstacles have you encountered?