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Find additional QAPI-related tools and resources on CMS's official QAPI website.

Particularly useful are:

QAPI at a Glance, a step-by-step guide to help nursing homes establish a foundation for QAPI

The QAPI Self-Assessment, which your team will find valuable to complete at the beginning of your QAPI journey and at regular intervals thereafter as you monitor your progress

NHQCC participants:
To submit your QAPI results to Qualis Health, please use our SurveyMonkey form.

Tools to break writer's block!
Start with the Guide for Developing Purpose, Guiding Principles and Scope for QAPI, which builds a framework for the Guide for Developing a QAPI Plan

A description of each of QAPI's five elements

Quality Assurance and Performance Improvement (QAPI) plans are important tools in the service of improving the quality of life, care, and services in nursing homes. Under the Affordable Care Act, all nursing homes are required to implement a QAPI program.

Sample QAPI Plan
Use our sample plan, along with the CMS resources highlighted in the sidebar of this webpage, to guide the development of your nursing home's QAPI Plan.


QAPI Land game

In 2013, Qualis Health developed a tool called "QAPI Land" as an engaging way to work through the 12 steps to achieve full implementation of your QAPI program. It proved to be such a successful and popular tool that we decided to share it with all interested audiences. Download the QAPI Land tool and the accompanying instructions. A recorded webinar, "Introduction to QAPI Land" is also available.


Implementation Ideas

As you prepare to move toward a more pro-active, data-driven approach to quality improvement there are many aspects of the culture of the workplace to consider. Below are some links to tools and programs that you may use to develop a culture that will support QAPI.

AHRQ Survey on Patient Safety Culture
Are you interested in measuring the safety culture in your home? Use this standardized, reliable, and free questionnaire developed by the Agency for Healthcare Research and Quality (AHRQ). To see how your nursing home compares to others across the country, see the 2014 User Comparative Database Report.

Patient Safety and the "Just Culture": A Primer for Health Care Executives
This classic analysis (written in 2001) outlines the complexities of individual accountability, disciplinary measures, and the idea of a blameless culture in healthcare. Four key behaviors are examined from a healthcare perspective: human error, negligence, reckless conduct, and knowing violations.

Lean Methodology
Learn about this system of eliminating waste and adding value to your process steps. Watch the Domestic Lean Goddess videos that show you how "Lean thinking" works.

Implementation guide, videos, training modules are all available here. Listen to the TeamSTEPPS Long-Term Care webinar. Access materials and videos referenced in the webinar.

IHI Training Videos: Using Data in QAPI

Join the Movement: IHI Open School 1:55 minutes

Whiteboard: Family of Measures 7:52 minutes 

Whiteboard: Pareto Analysis 7:01 (Great QI 201 content)

Whiteboard: Run Chart Part I 7:29 minutes and Part II 6:22 minutes

Whiteboard: Control Charts Part I 5:31 minutes and Part II 8:26 minutes

Whiteboard: Static vs Dynamic Data 6:39 minutes

Whiteboard: Flowchart 2 8:53 minutes

Other Resources


Racial disparities in healthcare are widespread. You might be surprised at the results of stratifying your QAPI analysis by race. To ensure that your organization is addressing the needs of all your residents, consider these resources for overcoming racial disparities.

Be sure to check out the QI Basics section of our website for resources related to conducting root cause analyses, PDSA cycles, and more.

Donna's Diary
A fictional diary of a Director of Nursing Services that will engage you in a discussion of QAPI principles and problem-solving on common clinical processes in nursing homes.

Developing an Effective Quality Assurance Program: Turning minimum requirements into a comprehensive strategy
This 2012 whitepaper by Upstairs Solutions provides an overview of QAPI and initial strategies for meeting the requirements.

Beyond the Quick Fix: The Medical Director's Role in Quality Assurance Performance Improvement (QAPI).
This article by Jane Pederson, MD is directed towards Medical Directors.

QAPI Overview Video
Stratis Health developed this 12-minute video overview of QAPI.