Quality Assessment and Performance Improvement for Medicare-Certified Agencies
Sets out the quality assessment and performance improvement (QAPI) program that 42 CFR §484.65 requires of a Medicare-certified home health agency: an agency-wide, data-driven program using OASIS-derived and other quality data, focused on high-risk, high-volume, and problem-prone areas and on adverse patient events, with documented performance improvement projects and governing body oversight. Also covers participation in the Home Health Quality Reporting Program (42 CFR §484.245) and the expanded Home Health Value-Based Purchasing Model (42 CFR §484.350). If the Agency is not Medicare-certified, the Agency follows the program design in this policy as its own standard, alongside Policy FL-HH-QA-01.
- Policy number
- FL-HH-QA-02
- Version
- 1.0
- Main rule
- 42 CFR §484.65
- Library
- Florida home health · 57 policies
- Category
- Quality
- Sections
- 20
In short
- If the Agency is Medicare-certified, it runs a QAPI program that uses data to make care safer and better.
- Accurate, on-time OASIS assessments matter: they measure how our patients do.
- Report every adverse event, such as a fall with injury or a medication error.
- You may be asked to help with an improvement project. Your ideas are welcome.
What's inside
20 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (42 CFR §484.65)
- 5. Program Scope
- 6. Program Data
- 7. Program Activities
- 8. Performance Improvement Projects
- 9. Executive Responsibilities
- 10. Home Health Quality Reporting Program
- 11. Expanded Home Health Value-Based Purchasing Model
- 12. Agencies That Are Not Medicare-Certified
- 13. Responsibilities
- 14. Records and Compliance Monitoring
- 15. Staff Training
- 16. References
- 17. Related Policies and Forms
- 18. Approval
- 19. Revision History
An inspector may ask
- Show me your QAPI program. What indicators do you track, and where do the data come from?
- What performance improvement projects did you conduct this year? Why did you choose them, and what measurable progress did you achieve?
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