The Quality Indicator Survey (QIS) is a revised long-term care survey process that involves two stages of review. In the first stage, preliminary investigations are conducted through structured resident, family, and staff interviews, resident observations, record reviews, and analysis of Minimum Data Set (MDS) data. These tasks, in combination with structured facility reviews, yield 162 Quality of Care and Quality of Life Indicators (QCIs) that are compared with national norms to identify Care Areas for further investigation in the second stage of the QIS survey. The second stage involves in-depth quality investigations using Critical Element Pathways that address assessment, care planning, care provision, and reassessment. The Care Areas are mapped to specific F tags.
A demonstration of the QIS in six states was begun in September 2005, led by Dr. Kramer's University of Colorado research team. Two survey teams in three states, Connecticut, Kansas, and Ohio, were initially trained in the QIS process. The training consisted of one week of classroom training, followed by a complete training survey. Subsequently, two surveys of record were conducted by each survey team during which University of Colorado trainers assessed surveyor compliance with QIS protocols. Beginning in February 2006, two additional survey teams were trained in California and Louisiana. Florida was added to the demonstration in October 2006 to test a statewide implementation approach to prepare for a national QIS rollout. Learn more about the status of the demonstration and the national rollout of QIS.
The Differences
The first year of the QIS process the number of deficiencies tripled in some of the centers we were involved with. One of the centers went from 7 deficiencies from their traditional survey to 22 deficiencies with the QIS process. The number of G tags as well as, IJ (immediate jeopardy) increased with the QIS survey. The QIS differs from the traditional survey in that it is computer driven, much more structured, uses a large sample size ( 70 resident records) regardless of the nursing home size, is objective and the statement of deficiencies is computer generated. Where the traditional survey focuses almost exclusively on the QI/QM report, the QIS process is more resident center focused and uses structured interview tools for the residents, families, staff and chart reviews. The data from these areas are then entered into the computer to generate 138 quality care indicators. If any of the 138 quality care indicators exceeds the national threshold, the area will then have an in-depth review to determine deficient practice. The in-depth review is done with a Critical Element (CE) tool. They are very lengthy and structured. For instance, the CE for pain is 11 pages long. By this time some of the centers in Connecticut have had two QIS surveys. The second survey has been better than the first QIS survey. It is because the centers knew what to expect. They knew how to prepare. They could anticipate the process. http://www.smcclinicalconsulting.com/nursing-home-administration.html
Ref: S&C-10-27-NH--Advance Copy - Description of Temporary Changes to Appendix P, State Operations Manual (SOM), Traditional Survey Process for Long Term Care Facilities (LTC) as a Result of the Minimum Data Set (MDS) 3.0 Implementation October 1, 2010 (7/2010)
Admin Info: 10-21-NH/QIS-- Nursing Homes: Revision of the Process for Training Additional or Replacement CMS-Certified Quality Indicator Survey (QIS) Trainers (5/2010)
Quality Indicator Survey
The Quality Indicator Survey (QIS) is a revised long-term care survey process that involves two stages of review. In the first stage, preliminary investigations are conducted through structured resident, family, and staff interviews, resident observations, record reviews, and analysis of Minimum Data Set (MDS) data. These tasks, in combination with structured facility reviews, yield 162 Quality of Care and Quality of Life Indicators (QCIs) that are compared with national norms to identify Care Areas for further investigation in the second stage of the QIS survey. The second stage involves in-depth quality investigations using Critical Element Pathways that address assessment, care planning, care provision, and reassessment. The Care Areas are mapped to specific F tags.