State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. 8.2 Other Suggestions


A variety of other suggestions comments were also directed to the Federal Government.

  • Stakeholders in one state believe the Federal Government should be responsible for providing guidance to facilities on data accuracy and quality and, to that end, should update the Resident Assessment Instrument (RAI) manual and clarify instructions for coding the MDS.32

  • Stakeholders in several states indicated that the Federal Government should promote quality initiatives by functioning as a clearinghouse for clinical information and dissemination of best practices to facilities.

  • In one state, stakeholders voiced the desire for the AHRQ--which consists of researchers and evaluators with an impartial approach--to provide best practices information, rather than CMS.

  • Another stakeholder believed the role of the Federal Government should be to collect and manage data, and to produce national trends, leaving the states to take the lead on quality improvement programs. This stakeholder also felt there should be more emphasis on alternative care (home care, assisted living, etc.).

  • Some stakeholders were concerned that CMS would not sustain its interest in QIO initiatives.

32. Note that CMS is currently working on an updated RAI manual and clarified instructions for coding the MDS.

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