CMS QI Initiative CMS QI Initiative
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The Nursing Home Quality Improvement Initiative
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CMS began the Nursing Home Quality Improvement Initiative (NHQI) in April 2002 with a Pilot Project in six states. The initiative consists of two primary activities - providing information to consumers on quality measures, and QIOs working with nursing homes on quality improvement strategies. The initiative will be rolled out in all states in November 2002. Find detailed information and link to relevant sites below.
 HHS News Release detailing the November rollout of the Nursing Home Quality Initiative. (November 12, 2002) (link to HHS news page)
Fact Sheet about the Nursing Home Quality Improvement Initiative - Questions and answers. (Updated October 24, 2002). This document provides an overview of the initiative and is a good basic training tool for ombudsmen and the general public.
PowerPoint Presentation: David Schulke presented this overview of the project to State and Local Ombudsmen in April and June 2002.
NCCNHR Press Release. Applauds spotlight on quality of care in nursing homes (April 24, 2002).
NCCNHR Press Release (November 12, 2002). Praises CMS initiative to improve public access to nursing home quality information .
List of newspapers carrying the ads for the national rollout, November 12, 2002.
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CMS Initiative Activities:
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Key Components of the National Initiative: The following presentations at the July AHQA conference explain the different aspects of the initiative.
QIO lessons learned from the pilot project, presented July 24, 20002 at the AHQA conference in Baltimore.
Press release and ads were distributed to the media. See newspaper distribution list for the pilot states.
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Ombudsman Involvement in Initiative:
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HHS announcement of new initiative supporting ombudsman efforts to help consumers use nursing home quality information.
AoA media advisory on ombudsman partnership with QIOs (May 21, 2002).
Ombudsman/QIO relationships in the initiative were defined by CMS and AoA based on the experience of the pilot states. Assistant Secretary Carbonell distributed the document in August 2002. (pdf version of document)
Advice for Ombudsmen in Preparing for the Nursing Home Quality Improvement Initiative (April 19, 2002). Prepared by ORC to assist ombudsmen in readying for an increased volume of calls as a result of media publicity in their communities.
Web-enhanced conference calls held in November to train state and local ombudsmen (November, 2002) Call I of series included:
CMS Initiative Overview A PowerPoint presentation by Barbara Paul, MD.
Excerpts from the NHQI training curriculum for Long Term Care Ombudsmen. Developed by Sara Hunt.
Information from the Pilot States
Washington State Ads (Nov. 2002) Washington has produced a series of ads that will appear along with the national rollout. Please note: these ads cannot be used by others without the permission of Qualis Health.
Washington State Ombudsman Kary Hyre presented an ombudsman perspective at the AHQA conference in Baltimore July 24, 2002. (Remarks and handouts coming to this site soon.)
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Quality Measure Information:
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What Are Nursing Home Quality Measures. Prepared by the American Health Quality Association (AHQA), April 2002.
Risk Adjustment & Quality Measurement in the Nursing Home Public Reporting Pilot Project: A Comparison with Current Measures. Prepared by AHQA, April 2002.
"Validation of Long Term and Post-Acute Care Quality Indicators." This report prepared for CMS examines 45 different quality measures. August 2, 2002.
Quality Measures for 2002 Rollout CMS report that spells out details of the quality measures for fall rollout. Clarifies differences between pilot project measures and national rollout measures. August 9, 2002.
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Quality Improvement Strategies for Nursing Home Improvement:
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"Improving Nursing Home Quality" by David Gifford, MD MPH explains the quality improvement processes that QIOs will be using with select nursing homes in each state. AHQA conference July 25, 2002.
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Quality Care Indicators. Special Section from NCCNHR's "Quality Care Advocate," April/May 2000:
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Quality Indicator Reports: Use when you can get them and be Cautious (pdf )
Facility Quality Indicator Profile - Sample
QI’s: New Tool for Nursing Home Consumers by Morris J. Kaplan, Esq., NHA (pdf)
QI’s: A Potential Resource for Consumers in Monitoring Care by David R. Zimmerman, Ph.D. (pdf)
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Education and Training Tools:
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Consumer Guide to Choosing a Nursing Home. Published by NCCNHR, this document advises consumers on the use of various information resources. (pdf version)
NHQI Curriculum excerpts for LTCOP.
This information includes several resources being distributed by NASUA as part of the NHQI Pilot Project supported by the Centers for Medicare and Medicaid Services and the Administration on Aging in order to foster partnerships between the Long-Term Care Ombudsman Program and the Quality Improvement Organizations, ensure that the LTCOPs are involved in the national rollout of the Nursing Home Quality Initiative (NHQI), and to help older people and their families use the NHQI as they make nursing home placement and quality of care decisions.
Transmittal letter November 8, 2002
Curriculum excerpts for ombudsman training
PowerPoint presentation for ombudsman training
PowerPoint presentation for consumers' use of quality measures
American Health Quality Association website at www.ahqa.org provides a description about the QIO role in the Quality Initiative. Presentations and agenda from AHQA conference on the initiative, July 24-25, 2002.
The Centers for Medicare and Medicaid Services (CMS) website at www.cms.hhs.gov has information regarding the nursing home quality initiative including a letter sent from CMS to the administrators of nursing homes in the six pilot project states.
The Nursing Home Compare site at www.medicare.gov displays the quality measure data for the six pilot states and the resident indicators for the non-pilot states.
Nursing Homes: Federal Efforts to Monitor Resident Assessment Data Should Complement State Activities (February 2002). This report is published by GAO and can be retrieved on line by going to www.gao.gov. You may search by title or use the document number GAO-02-279.
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