A. Recognizing that quality, as defined in QIS, has become an expectation of all nursing homes over the past five years, providers can and should incorporate the standards and tools of the QIS into care.

With 25 states and the District of Columbia having completed or begun implementing the QIS, a critical mass exists for change to a more resident-centered survey process that is influencing providers and agencies in all states.

More importantly, residents and families are seeking long term and post-acute care environments where quality of life is more of a focus.

Evidence of the latter is the growth of the culture change movement and the expansion of alternatives to nursing homes. That said, nursing homes are expected to keep an increasingly frail group of residents safe, healthy, and satisfied, which is no small challenge.

Providers need not wait until the QIS comes to their state agency to meet this new standard for care. The quality metrics contained in the QIS comprehensively define measurements for today’s expectations of nursing homes.

QIS metrics cover quality-of-life issues such as dignity and choices; quality-of-care issues, such as adequate staffing to meet resident needs and off-label use of antipsychotics; and post-acute care quality, such as readmission to hospital and rehabilitation outcomes, to name just a few.

Nursing homes can use these tools to assess all of these areas.

Starting today, providers should measure themselves based on the full set of QIS assessments. This is the first step. There are numerous situations where even high-performing organizations find areas where they can improve.

The second step is to conduct a root-cause analysis of chosen areas of concern using the many tools that exist to help providers do this—to identify units and systems where problems occur.

The third step is corrective actions utilizing resources for all disciplines to assist providers.

The fourth step is for providers to measure themselves again to see if they have achieved the desired improvement.

Sound familiar?

Yes, in simple terms this is quality assurance and performance improvement. The challenge is that this is not simple to do, and it takes time to complete the improvement cycle of assessment, improvement, and re-assessment.

So take advantage of the hiatus in the QIS rollout to build Quality Assurance and Performance Improvement systems around the QIS assessments and tools.