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Part III Standards for Compliance

BOX 22.2 Timeline for Quality Assurance and Performance Improvement Development March 2010

September 2010

Affordable Care Act enacted. Section 6102 (c) states that every nursing home must have a QAPI program plan. Legislation requires CMS to establish QAPI program standards and provide technical assistance.

CMS contracted with the University of Minnesota and its subcontracting partner, Stratis Health, to conduct a demonstration project that will develop and test materials to inform a national QAPI rollout.

September 2011–August 2013 Two-year demonstration program launched to prepare for national implementation

2011–2013 2012

2014 TBD TBD

CMS strategy includes outreach to multiple stakeholders and partners in this process.

CMS issued QAPI at a Glance as a 43-page PDF (www.cms.gov/Medicare/ Provider-Enrollment-and-Certification/QAPI/Downloads/QAPIAtaGlance. pdf).

CMS issued first set of QAPI tools as a 3-page PDF Final rule issued

One year after final rule issued, all nursing homes must have QAPI in place.

(CFR) 42 CFR, Part 483.75(o) “specifies the QAA committee composition and frequency of meetings in nursing facilities and requires facilities to develop and implement appropriate plans of action to correct identi- fied quality deficiencies. This provision provides a rule but not the details as to the means and methods taken to implement the QAA regulations.” As the facility’s nutrition expert, it is important that the RDN be involved in this process and work with others in

developing and implementing the QAPI program within the department as well as facilitate nutrition processes within other QAPI projects. “CMS is rein- forcing the critical importance of how nursing facilities establish and maintain accountability for QAPI pro- cesses in order to sustain quality of care and quality of life for nursing home residents” (1).

Figure 22.1 Five Elements for Framing Quality Assurance and Performance Improvement in Nursing Homes

Systematic analysis and systemic action

Performance improvement projects Governance and leadership Design and scope

Feedback, data systems, and monitoring

Source: Center for Medicare and Medicaid Services. QAPI at a glance: A step by step guide to implementing quality assurance and performance improvement (QAPI) in your nursing home. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/ Downloads/Survey-and-Cert-Letter-13-05.pdf. Accessed November 5, 2015.