Report details new CMS quality improvement indicator tool

Quality Indicator Survey inspectors are beginning to use new software that works with personal tablet computers during their nursing home visits, according to a new Government Accountability Office report.

The report, “Nursing Home Quality: Implementation of the Quality Indicator Survey,” discusses the new software and the timeline for its implementation throughout the states. The software will walk surveyors through the inspection process to verify they ask the correct questions, consider quality standards, record observations and view guidance throughout the process. One advantage of using the new QIS software, compared to traditional methods, is that it allows surveyors to draw a larger, random sample of up to 70 residents, officials say. The traditional process relies on surveyors’ use of reports, data sets, guidance, and professional judgment when choosing up to 20% of the residents who might be at risk for poor quality of care, according to the report.

CMS officials say that training all of a given states’ surveyors on the tool could take one to three years, according to the GAO. The first training period began in 2009. The last will begin between June 2014 and June 2015, which means all surveyors might not complete their training until 2018. Budgetary factors also might cause states to delay training, with some states reporting problems affording tablet PCs for their surveyors. CMS officials have indicated that QIS implementation is mandatory. Until everyone is trained, however, states are allowed the option of using the QIS or traditional methods to complete inspections.

As of February, seven states had completed training surveyors on the tool and 14 states had started training inspectors. Thirty-two state agencies are in line to start training surveyors between now and 2015.