State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Management and Staffing


Technical assistance visits are conducted by seven QIPMO nurses, with each nurse covering one of the seven geographic areas of the state. Requests for visits are received by the program coordinator at the University School of Nursing who in turn contacts the nurse covering that particular region. Educational programs are provided by both the QIPMO nurses and Marilyn Rantz. Nurses meet monthly, rotating between an in-person meeting and a conference call. The main purpose of these meetings is to be certain that they are providing consistent information. On a quarterly basis, a nurse from one area will accompany a team in another region in a peer review process to ensure that they are providing information in a consistent manner and that the processes are following QIPMO guidelines.

The QIPMO nurses are gerontological clinical nurse specialists, some with advanced degrees, selected for their clinical expertise and general lack of knowledge of the regulatory process. They are not surveyors, are not survey trained and not currently or in the past affiliated with the state survey agency. Marilyn Rantz, who has a master's degree in education and has done technical assistance in the past, provides training for the QIPMO nurses using role modeling and coaching methods. Dr. Rantz points out that "a nurse is not a nurse is not a nurse," emphasizing that the clinical skills of the QIPMO nurses are key. She states that not just any nurse can do the type of technical assistance that is required in these situations. The technical assistance nurses need to be expert nurses who can help the facilities change their belief systems.

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