Quality Assurance/Performance Improvement (QAPI)

​​​​Section 6102(c) of the Affordable Care Act required that all skilled nursing centers develop Quality Assurance and Performance Improvement (QAPI) programs. The QAPI requirements were included in the Centers for Medicare and Medicaid Services’ (CMS) revised Requirements of Participation (​RoP) for nursing centers, published in October 2016. The stated purpose and intent of the QAPI regulations is to “develop, implement, and maintain an effective comprehensive, data-driven QAPI program that focuses on systems of care, outcomes of care, and quality of life. 

Quality Assurance and Performance Improvement (QAPI) is a data driven and proactive approach to quality improvement. It combines two approaches - Quality Assurance (QA) and Performance Improvement (PI). QA is a process used to ensure services are meeting quality standards and assuring care reaches a certain level. PI is a pro-active approach that continuously studies processes with the goal to prevent or decrease the likelihood of problems in care delivery.

All members at all levels of an organization, including residents, are involved in continuously identifying opportunities for improvement. Gaps in health care systems are addressed through planned interventions. The goal of QAPI activities is to improve the overall quality of life and quality of care and services delivered to nursing home residents. Additionally, although not regulatory required, Assisted Living Providers have found that they benefit from using QAPI framework to develop improvement programs.


AHCA/NCAL has free tools, resources, webinars and programs to assist our members in developing and sustaining an effective and comprehensive QAPI program​. 


​Members can access free resources and tools on ahcancalED, the Association’s education portal. To get started, members should download the following QAPI specific resources:
  • QAPI Prep Course: This five-course program is a great resource to help members of the Quality Assessment and Assurance (QAA)committee take the requirements of QAPI and turn them into practice. The program is eligible for continuing education hours (CEs) from both the American Nurses Credentialing Center (ANCC) and the National Association of Long Term Care Administrator Boards (NAB).
  • 12 Action Steps: This document condenses the information from CMS’ QAPI at a Glance, highlighting the 12 steps members can take to get started with QAPI.
  • QAPI Drilldown Tools: These 8 tools can be downloaded and used to help members anticipate and examine which factors will negatively impact falls, antipsychotic medication, pressure sores, and rehospitalizations.
  • QAPI Meeting Templates: These templates, including meeting agenda and meeting minutes templates, can be downloaded and customized to assist member’s unique priorities and QAPI efforts.

 National Quality Award Program

​The AHCA/NCAL National Quality Award program is based on the Baldrige Performance Excellence Criteria, a nationally recognized method known for improving business performance. The Baldrige Criteria will help centers prepare for QAPI requirements through a focus on systematic action, data-driven decisions and continued learning and development.

Centers who participate in the Quality Award program will be better prepared to meet the requirements of QAPI. Learn more about the connection of the Requirements of Participation and Baldrige.

 ‭(Hidden)‬ The Quality Initiative

The AHCA/NCAL Quality Initiative​ ​challenges members to meet measurable targets in specific focus areas important to overall organizational success. These areas are aligned with QAPI and the Requirements of Participation.