John O'Connor, editorial director, McKnight's Long-Term Care News
John O’Connor, editorial director, McKnight’s Long-Term Care News

The Centers for Medicare & Medicaid Services may be asking you for help this summer. It might behoove you to sit up and take notice.

The government agency has targeted more than 4,200 facilities as part of a larger initiative to improve the way facilities operate.

The Quality Assurance and Performance Improvement program was created as part of the Affordable Care Act. Selected operators will be notified that they have been chosen for participation via their Quality Improvement Evaluation System mailbox. Facilities then will be able to choose how they would like to respond; they can complete an online questionnaire or have a hard copy mailed to their facility. CMS estimates that the questionnaire will take about 20 minutes to complete.

Later this summer, CMS plans to roll out prototype tools on its QAPI webpage. This is no small consideration, as it will give you a chance to try them out and provide feedback.

According to CMS, successful QAPI program will have five major elements.

1) Design and Scope — A QAPI program must be ongoing and comprehensive, dealing with the full range of services offered by the facility, including the full range of departments. When fully implemented, the program should address clinical care, quality of life, resident choice, and care transitions.

2) Governance and Leadership — The governing body and/or administration of the nursing home develops and leads a QAPI program that involves leadership working with input from facility staff, as well as from residents and their families and/or representatives.

3) Feedback, Data Systems and Monitoring — The facility puts in place systems to monitor care and services, drawing data from multiple sources.

4) Performance Improvement Projects — The facility conducts Performance Improvement Projects (PIPs) to examine and improve care or services in areas that are identified as needing attention.

5) Systematic Analysis and Systemic Action — The facility uses a systematic approach to determine when in-depth analysis is needed to fully understand the problem, its causes, and implications of a change.

Even if you are not participating in such a program, it’s not a bad idea to master these five elements. For as many experienced providers can attest, CMS has a habit of turning suggestions into mandates.