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It emphasizes continuous attention to quality of care, quality of life, and resident safety by requiring systematic identification, reporting, investigation, analysis, and prevention of adverse events. The checklist aligns facility actions with Requirements of Participation language, including program design, documentation evidence, staff education, governance, and corrective action effectiveness monitoring.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/quality-assurance-and-performance-improvement-policy-and-procedure-checklist-qapi/263423/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/quality-assurance-and-performance-improvement-policy-and-procedure-checklist-qapi/263423.png","ImageObject",442,249,{"name":88,"@type":89},"8796093062539","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-25","2026-09-14",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",6,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What is the purpose of the QAPI policy in this checklist?","Question",{"text":109,"@type":110},"The checklist’s purpose is to define a process for developing a QAPI plan that ensures ongoing quality improvement activities lead to improvements in residents’ lives, quality of care, quality of life, and resident safety.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What documentation and evidence does the facility need to maintain for its QAPI program?",{"text":114,"@type":110},"The facility must maintain documentation demonstrating an ongoing QAPI program, including systems and reports for systematic identification, reporting, investigation, analysis, and prevention of adverse events, along with documentation for development, implementation, and evaluation of corrective actions or performance improvement activities.",{"name":116,"@type":107,"acceptedAnswer":117},"How should the QAPI program be designed and what should it cover?",{"text":118,"@type":110},"The program must be ongoing and comprehensive, addressing the full range of care and services, including all systems of care and management practices, clinical care, quality of life, and resident choice, using the best available evidence to define and measure quality indicators and facility goals.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},263423,1790052861,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":60,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":135,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":42},8796093062539,"Quality Assurance and Performance Improvement Policy and Procedure Checklist  \nPurpose and Intent of §483.75(a‐g)  \nThe purpose of the Quality Assurance and Performance Improvement (QAPI) policy is to outline a process for development of a QAPI plan. These requirements are intended to ensure facilities develop a plan that describes the process for conducting QAPI/QAA activities, such as identifying and correcting quality deficiencies as well as opportunities for improvement, which will lead to improvement in the lives of nursing home residents, through continuous attention to quality of care, quality of life, and resident safety.  \nTo assure that the individual facility has followed all the required steps for the development and implementation of a Quality Assurance and Performance Improvement Plan in accordance to the new Requirements of Participation (RoP), the following checklist captures specific action items for successful completion. The left column represents the actual Requirements of Participation (RoP) language and the right column indicates specific leadership strategies for successful completion and implementation of the revised RoP. When preparing updated policies and procedures, it is recommended to include actual RoP language as applicable.  \nSuggested Checklist  \nProgram and Policy and Procedure  \n\n| Regulation | Recommended Actions |\n| --- | --- |\n| F865\u003Cbr>§483.75(a) Quality assurance and performance improvement (QAPI) program\u003Cbr>§483.75(a)(1)\u003Cbr>Maintain documentation and demonstrate evidence of its ongoing QAPI program that meets the requirements of this section. This may include but isnot limited to systems and reports demonstrating systematic identification, reporting, investigation, analysis, and prevention of adverse events; and documentation demonstrating the development, implementation, and evaluation of corrective actions or performance improvement activities;\u003Cbr>§483.75(a)(2)\u003Cbr>Present its QAPI plan to the State Survey Agency no later than 1 year after the promulgation of this | 􀂈 Review, develop and/or implement the Quality Assurance and Performance Improvement Plan in |\n|  | accordance with the (RoP) . See regulatory requirements as well as template plan, policy and procedure. |\n|  | Due by November 28, 2017. |\n|  | 􀂈 Assure that plan describes the process for identifying and correcting quality deficiencies and contains the |\n|  | necessary components such as:\u003Cbr>(A) Tracking and measure |\n|  | performance;\u003Cbr>(B) Establishing goals and thresholds |\n|  | for performance measurement; |\n\nThis document is for general informational purposes only.  \nIt does not represent legal advice nor relied upon as supporting documentation or advice with CMS or other regulatory entities.© Pathway Health Services, Inc.– All Rights Reserved – Copy with Permission Only ‐ 2017  \n| regulation; [§483 .75(a)(2) implemented November 28, 2017 (Phase 2)]\u003Cbr>§483.75(a)(3)\u003Cbr>Present its QAPI plan to a State Survey Agency or Federal surveyor at each annual recertification survey and upon request during any other survey and to CMS upon request;\u003Cbr>§483.75(a)(4)\u003Cbr>Present documentation and evidence of its ongoing QAPI program's implementation and the facility's compliance with requirements to a State Survey Agency, Federal surveyor or CMS upon request.\u003Cbr>§483.75(b) Program design and scope.\u003Cbr>A facility must design its QAPI program to be ongoing, comprehensive, and to address the full range of care and services provided by the facility. It must:\u003Cbr>§483.75(b)(1) Address all systems of care and management practices;\u003Cbr>§483.75(b)(2) Include clinical care, quality of life, and resident choice;\u003Cbr>§483.75(b)(3) Utilize the best available evidence to define and measure indicators of quality and facility goals that reflect processes of care and facility operations that have been shown tobe predictive of desired outcomes for residents of a SNF or NF.\u003Cbr>§483.75(b)(4) Reflect the complexities, unique care, and services that the fac","cbCailt9FmuvMVRe","https://ap.wps.com/l/cbCailt9FmuvMVRe","pdf",2046347,85,"English","# Purpose and Intent\n## Quality Assurance and Performance Improvement Program Requirements\n## Program Design and Scope\n## Governance and Leadership","[{\"question\":\"What is the purpose of the QAPI policy in this checklist?\",\"answer\":\"The checklist’s purpose is to define a process for developing a QAPI plan that ensures ongoing quality improvement activities lead to improvements in residents’ lives, quality of care, quality of life, and resident safety.\"},{\"question\":\"What documentation and evidence does the facility need to maintain for its QAPI program?\",\"answer\":\"The facility must maintain documentation demonstrating an ongoing QAPI program, including systems and reports for systematic identification, reporting, investigation, analysis, and prevention of adverse events, along with documentation for development, implementation, and evaluation of corrective actions or performance improvement activities.\"},{\"question\":\"How should the QAPI program be designed and what should it cover?\",\"answer\":\"The program must be ongoing and comprehensive, addressing the full range of care and services, including all systems of care and management practices, clinical care, quality of life, and resident choice, using the best available evidence to define and measure quality indicators and facility goals.\"}]","Quality Assurance and Performance Improvement Policy and Procedure Checklist - QAPI | PDF",1789370871]