Resident assessments and care planning quality are threatened by nurses' unrelated duties, survey fi

The Centers for Medicare & Medicaid Services still cannot say when an official regulation will be established for the Quality Assessment and Performance Initiative, but that’s not stopping the agency from moving forward with QAPI initiatives. 

CMS does not have “definitive or general knowledge of timelines” related to the QAPI regulation, officials said during an Open Door Forum call Thursday. Nursing home operators were supposed to have implemented the QAPI program in March, per the Affordable Care Act.

Despite this continuing delay, CMS recently launched a new webpage with QAPI resources. Providers should feel confident they will be well prepared for QAPI by following the recommendations in these online materials, CMS project officer Deborah Lyons, RN, said in response to a question from McKnight’s.

“We here at CMS have worked very closely with the group developing the regulation,” Lyons said. “These [resources] will not conflict in any way with any regulation, we feel certain.”

Surveyors are learning QAPI fundamentals, but will not use QAPI principles in surveys until the official rule is promulgated, Lyons stressed. Until then, surveyors will rely on the existing quality assurance and assessment guidelines. CMS administrators and the group working on the regulation are discussing how QAPI will relate to existing guidelines.

Cheryl Wiseman, with the CMS Quality Measurement and Health Assessment Group, addressed MDS issues. 

There is an error in Chapter 5, Section 5.2 of the most recently updated RAI manual, Wiseman said. The manual erroneously states that admissions assessments must be completed “no more than 13 days after the assessment reference date.” Wiseman said this will soon be corrected to say, “no more than 13 days after the entry date.” 

There have been problems accessing a recently posted training video on discharge assessments and the use of dashes in MDS coding, Wiseman acknowledged. The video is available through YouTube only, which Wiseman said has caused some “angst.” She recommended that workers view the video from personal computers if workplace systems block access. PowerPoint slides on the topics will be available for download soon, she said. 

CMS officials recommended that providers consult the Unified Agenda webpage for updates on the QAPI regulation: www.reginfo.gov/public/do/eAgendaMain. Providers can also access a McKnight’s webcast on QAPI by clicking here.