State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. 4.0 the Wider Context of State-Initiated Quality Improvement


In addition to the TA programs reviewed in Chapter 3, the states we studied all had initiated additional state-initiated quality improvement efforts. In addition to technical assistance programs, the four most commonly initiated practices included:

  • dissemination of information to the public about the quality of the state's long-term care facilities;
  • dissemination of best practice guidelines (in addition to best practice information disseminated by the quality improvement/technical assistance programs discussed in section 3.2);
  • programs that recognize and reward facilities doing exemplary work; and
  • additional training for nursing home providers.

This section presents information on each of these four program categories, including the differing approaches states have taken to implement them, the nature of their interaction with TA programs, the perceived positive and negative aspects of each program, and their potential impact on quality. Readers interested in learning more about these programs, as well as the other activities listed in Table 2, are directed to the state reports included in the Appendices at the end of this document.

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