An Accountable Care Act quality assurance program has the power to be transformative, a training expert said at the LeadingAge annual meeting Tuesday.

The final rule for Quality Assurance Performance Improvement is expected in 2013, and a year after then, providers must have a QAPI in place, Care2Learn/Upstairs Solutions president Tamar Abell said. QAPI plans should include five elements: 1) Design and Scope; 2) Governance and Leadership; 3) Feedback, Data Systems and Monitoring; 4) Performance Improvement Projects; and 5) Systematic Analysis and Systemic Action.

“QAPI is systems, systems, systems,” Abell said. Providers not only have to have the data, but also be able to explain it. In addition, they should be able to perform a root-cause analysis to make sure they understand what is resulting in a problem.

In the area of performance improvement plans, Abell recommends choosing two areas that need attention, with one being clinical, such as eloping or pressure sores. Another area, such as laundry, can involve the entire staff and focus around culture change.

A critical part is, “How are you training and how are you tracking your training?” she said. That could include involving families in training on topics such as understanding falls.

Training also was tackled in the LeadingAge session “Sex in Long-Term Care.” Certified nursing assistants need more training in addressing the issues of sexuality among residents, advised Merea Bentrott, a Ph.D. candidate at Iowa State University in Ames, IA.

“A lack of knowledge or misinformation can lead to ignoring sexual behaviors,” Bentrott noted. Training can help “alleviate the hesitancy to ask questions and report incidences of sexual expression.”

The LeadingAge convention concludes Wednesday in Denver.