It’s QAPI Time!

QAPI will soon be in the spotlight.  All skilled nursing facilities, by November 28 of this year, must have their QAPI plan ready to provide to the Annual Survey.  For those who don't have their plan in place, here is a quick QAPI primer.


What Is QAPI?

QAPI stands for Quality Assurance / Performance Improvement.  The ultimate goal is a “data-driven, proactive approach to improving the quality of life, care and services in nursing homes” achieved through the combined elements of both practices (QA and PI).

The CMS QAPI Guide illustrates the merging of the concepts by highlighting their different approaches to quality management:


Quality Assurance (QA)

Performance Improvement (PI)


Measuring compliance
with standards

Continuously improving
processes to meet standards





Required, reactive

Chose, proactive


Individuals/outliers (“bad apples”)

Processes or Systems


Medical provider

Resident care




Combine both and you arrive at the end result:  QAPI = QA + PI


Why Do I Care?

Section 6102(c) of the Affordable Care Act requires all skilled nursing facilities develop a QAPI program (Phase II), with CMS directed to develop a QAPI prototype program (Phase I) along with standards, technical assistance and best practices guidance.  CMS completed Phase I on November 28, 2016 – which means the deadline for Phase II (provide an initial QAPI plan for your facility to the State Agency Surveyor at your annual survey) is November 28, 2017.  The Phase III (have the QAPI plan implemented) deadline is November 28, 2019.


What Do I Need to Do?

Time to develop your QAPI plan.  Per CMS guidelines, five program elements need to be included in your QAPI plan:

  • Design and Scope
  • Governance and Leadership
  • Feedback, Data Systems and Monitoring
  • Performance Improvement Projects (PIPs)
  • Systematic Analysis and Systemic Action


Where Can I Find Resources?

The good news is that there are many resources available to assist you in the development of your QAPI plan (including program guides, worksheets, assessments, checklists and planners).  Check out our website for links to over two dozen resources you can access for assistance.  Our QAPI experts are also available to help answer your questions.