Time constraints limited exploration of this issue to a brief discussion with DHS staff involved in the new quality improvement projects. They offered the following comments and suggestions:
The new "Quality Improvement Organizations" (QIOs) funded by the Federal Government appear to offer the potential to help states such as Texas leverage their own quality improvement projects; the QIOs should be funded appropriately and encouraged to work closely with states.
Additional federal support for developing, implementing, and evaluating innovative quality improvement projects would be helpful.
Federal regulations are so complex that many homes have great difficulty even understanding the requirements; in addition, trying to get over 1000 nursing facilities in 254 counties in compliance is very challenging. Greater attention to simplification and regulatory moderation would be appreciated.