Quality Assurance/Performance Improvement (QAPI) regulation was advanced as a part of the Affordable Care Act (ACA) of 2010, but the basic premise is not entirely new to long-term post-acute care (LTPAC) providers. The initiative expanded the existing Quality Assessment and Assurance (QAA) provision, thus “reinforcing the critical importance of how nursing facilities establish and maintain accountability…in order to sustain quality of care and quality of life for nursing home residents.” The Centers for Medicare and Medicaid Services has linked these initiatives to reimbursement, furthering the underlying tenet of value-based purchasing-paying for performance based upon resident-centric outcomes.
QAPI takes the QAA regulations further by incorporating root cause analysis and performance improvement guidelines. While Quality Assurance QA is the assessment of how well the facility is doing, Performance Improvement (PI) is the application of corrective actions and improvement of performance in a monitored and measured approach. The expectation is that LTPAC providers will continue to question and refine processes until optimal outcomes are met. The goal of QAPI is to improve processes in the delivery of care and ultimately improve patients’ quality of life, as well as overall quality of care.If you work in a Long Term Post-Acute Care (LTPAC) setting, you know that in our field the only constant is change. There is, however, one process that has been with us, in one form or another, for quite a long time. Until recently, Quality Assurance and Performance Improvement were two separate processes. These have since been streamlined into what we now know as the QAPI (Quality Assurance/Performance Improvement) process. Let’s start off with the CMS definition of QAPI:
