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​Section 6102(c) of the Affordable Care Act requires that all skilled nursing ACA_QAPI CROPPED.png
care centers develop Quality Assurance and Performance Improvement (QAPI) programs. The statute requires the Centers for Medicare & Medicaid Services (CMS) to develop a prototype QAPI program, establish standards, and provide technical assistance to centers on the development of best-practices in order to meet such standards. One year after a final rule for QAPI is issued, all nursing centers must have in place and implement an acceptable QAPI plan.

 What is QAPI?


​QAPI is defined by CMS as “an initiative that goes beyond the current Quality Assessment and Assurance (QAA) provision, and aims to significantly expand the intensity and scope of current activities in order to not only correct quality deficiencies (quality assurance), but also to put practices in place to monitor all nursing home care and services to continuously improve performance.”

  • Quality Assurance (QA) = the process of meeting quality standards and assuring that care reaches an acceptable level.
  • Performance Improvement (PI) = continuously analyzing your performance and developing systematic efforts to improve it; also known as Quality Improvement.

QAPI is not all new; many centers already incorporate elements of QAPI in their daily work. Quality concepts/programs such as continuous quality improvement (CQI), Advancing Excellence (AE) and the AHCA/NCAL National Quality Award program all directly align with the principles of QAPI.


 The 5 Elements


The QAPI framework is established through five “elements.” Each element describes an important component of QAPI, and all elements are interconnected.

A full description of these elements can be found on this handout from CMS.


 When will the regulations be released?


​A pilot is currently underway with 17 centers in four states (Florida, Minnesota, California, and Massachusetts).  In early May 2013, CMS released a new website with tools and resources to help members get started on QAPI.

The regulations are anticipated to be released by 2014. AHCA will continue to update members as more information is available.


 Getting Started


AHCA has developed a summary of the CMS "QAPI: At a Glance" document, highlighting the 12 steps members can take to get started with QAPI. Members are encouraged to download this document today to get started with QAPI and take the first steps toward becoming QAPI prepared!

Download the 12 Action Steps (members-only, log-in required)