LeadingAge New York Adviser Adviser LeadingAge NewYork Spring 2019 final | Page 21
QAPI Phase III Requirements:
Data-Driven, Destination Quality
The Centers for Medicare and Medicaid Services (CMS) has created a momentum in quality for Skilled
Nursing Facilities (SNFs). The gold standard for quality is the Five-Star Quality Rating System. SNFs base their
reputations on the quality of care they provide. They know that a successful reputation ensures business
sustainability through attracting and retaining talented staff and achieving occupancy rates that reflect the
maximum number of and most desirable referrals.
Quality Assurance Performance Improvement (QAPI) is CMS’s approved method for improving the
quality of care and life for residents of SNFs. CMS incorporated a QAPI criterion into five of the
10 Requirements of Participation that were changed by the Final Rule, which is meant to have a
sweeping effect on the long term care industry. Not since the Omnibus Budget Reconciliation
Act of 1987 (OBRA ’87) have the Requirements of Participation been so radically
changed (enough so that the changes were phased in). The final phase, Phase III, has an
implementation date of Nov. 28, 2019, and the five changes are summarized below:
CFR § 483.12 Freedom from Abuse includes a requirement that all instances
or allegations of abuse be studied by establishing a policy and procedure that ensures
that reports are funneled through the QAPI Committee.
.
CFR § 483.70 Administration includes a requirement that the governing body have
responsibility and accountability for the QAPI program.
.
. CFR § 483.75 QAPI includes requirements that facilities develop, implement and maintain effective,
comprehensive, ongoing, data-driven QAPI programs that focus on systems of care, outcomes of care and
quality of life.
CFR § 483.80 Infection Control includes a requirement that the Infection Preventionist be a member of the
QAPI Committee and report on infections, monitoring efforts and prevention programs.
.
.
CFR § 483.95 Training Requirements include mandatory training for all staff regarding elements and goals of
the QAPI program.
A data-informed approach to quality has never been more important. No matter what rules change,
you can excel in quality improvement activities when you use LeadingAge New York Technology
Solutions’ suite of tools. Quality Metrics and the Five-Star Analysis Report are member benefit
tools that facilities use to custom benchmark themselves and improve their understanding
of the Five-Star Quality Rating System on Nursing Home Compare (NHC). There is
one drawback to using this data in QAPI activities, however: it can be three to six
months old, and in some instances, the residents included in those rates may
already be discharged from the facility. Our newest tool, Quality Apex, provides
users with quality measure rates based on their most recently uploaded Minimum
Data Sets (MDSs). If you are interested in learning more about the products we provide,
please contact Marguerite Carroll, business development liaison, LeadingAge New York, at
518-867-8383 or [email protected].
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