What is the QIS?
The QIS is a two-staged process used by surveyors to systematically review specific nursing home requirements and objectively investigate any regulatory areas that are triggered. Although the survey process has been revised under the QIS, the federal regulations and interpretive guidance remain unchanged. The QIS uses customized software (ASE-Q) on tablet personal computers (PCs) to guide surveyors through a structured investigation.
The QIS was designed to achieve several objectives:
- Improve consistency and accuracy of quality of care and quality of life problem identification by using a more structured process;
- Enable timely and effective feedback on survey processes for surveyors and managers;
- Systematically review requirements and objectively investigate all triggered regulatory areas;
- Provide tools for continuous improvement;
- Enhance documentation by organizing survey findings through automation, ultimately moving to a paperless survey process; and
- Focus survey resources on facilities (and areas within facilities) with the largest number of quality concerns.
QIS Work at the University of Colorado
The University of Colorado is under contract with the Centers for Medicare & Medicaid Services (CMS) to assist with national implementation and analysis of the QIS. The project team provides support to states on QIS implementation and operational issues, and creates, produces, and supports the use of Desk Audit Reports for State Agencies (DAR-SA) and Desk Audit Reports for Regional Offices (DAR-RO). The DAR-SA and DAR-RO, derived from QIS data, are used by state agencies and CMS regional offices to evaluate variation in QIS survey results and guide state and regional quality assurance activities.
The project team also is involved in efforts to further develop and refine QIS processes, procedures, and resources for surveyors and states. Such efforts include testing and revising QIS Stage 1 data collection instruments (resident interview, staff interview, family interview, resident observation, and record review); assisting with testing, redesigning, and providing training on the ASE-Q software used to collect, record, and analyze QIS findings; developing and providing training on new modules for QIS revisit and extended surveys; and developing and testing new federal comparative and oversight surveys, new quality indicators based on MDS 3.0, and new critical element pathways for care areas not currently associated with a pathway.