10 Tips to Help Nursing Homes Prepare for the Quality Indicator Survey (QIS)
The following are key tips from Ecumen Consulting Services to help nursing homes prepare for the QIS from the Centers for Medicare and Medicaid Services.
1. Think Ahead: Have the licensed staff become familiar with the questions that the surveyors will ask. Encourage the nurses to take their time when answering and to use the
MAR, TAR and chart when answering.
- Does the resident have an indwelling catheter?
- Does the resident receive a nutritional supplement?
- Does the resident have pressure ulcers?
- Does the resident use side - rails?
- Does the resident have any contractures?
- Has the resident had any falls or fractures in the past 30 days?
2. Updated Care Item Lists: Keep up to date lists of the care items asked in the questions above, place in plastic protective sleeve and keep in the MAR or TAR for quick reference. Do them in pencil for ease of making changes.
3. Diligence on Weight Monitoring: Have a good system in place for weight monitoring.
Weights for days 30, 60, 90 and 180 will be asked for.
4. Weekly Weightings: Weigh everyone weekly and alert dietary and the MD of gains or
losses of 3 lbs or more. It is best if the weight sheet shows the notification directly on it.
5. Monitor Room Trays: Follow room trays that are being delivered and evaluate potential
problems. The surveyor will follow room trays and ask many questions on weight loss
prevention.
6. Billing Logs: Keep a log of demand billing. If there have been no demand bills, the
surveyor will ask for the last 5 Medicare Denials. Deficiencies are issued for incomplete
Medicare Denials.
7. Audit Medicare Denials: Audit all Medicare Denials for completeness prior to filing in the
medical record.
8. Audit the Dining Experience: Audit and observe your dining experience. Surveyors are
no longer focused on specific people in the dining room, they are watching the entire
dining experience. Watch for room temperatures that are too cold or hot, lighting, staff
communication, food handling and variety of choices. Surveyors will stay in the dining
room during clean up to watch infection control practices.
9. Alphabetized Resident Census: Maintain an alphabetical resident census list with the
room numbers and units. They will want this immediately upon entering. Note on the
“alpha” list residents who are not in the nursing home (e.g. home visit, MD appointment, in
the hospital). Also maintain a list of those admitted and discharged over the last 30 days.
10. Specialized List: Maintain a list of residents who receive ventilator, dialysis (whether in
or outside the nursing home), certified Medicare hospice and or end of life services. This
information must be supplied within 4 hours of entrance to the nursing home.
Ecumen Consulting Services is a division of Ecumen (www.ecumen.org), the innovative leader of senior housing and services, empowering individuals to live richer and fuller lives. Ecumen Consulting Services provides long term care consulting, training, management, development and repositioning services for nursing homes, assisted living, Continuing Care Retirement Communities (CCRCs) and home care and community-based services.
Download: www.ecumen.org/app/webroot/files/file/White%20Papers/Preparing-for-QIS.pdf