What is QAPI

Working to improve the quality of care delivery to nursing home residents.

QAPI is the merger of two approaches to quality management, Quality Assurance (QA) and Performance Improvement (PI). Both involve seeking and using information, but they differ in key ways:

QA is a process of meeting quality standards and assuring that care reaches an acceptable level. QA is a reactive, retrospective effort to examine why a facility failed to meet certain standards.

PI (also called Quality Improvement or QI) is a pro-active and continuous study of processes with the intent to prevent or decrease the likelihood of problems by identifying areas of opportunity and testing new approaches to fix underlying causes of persistent/systemic problems. PI in nursing homes aims to improve processes involved in health care delivery and resident quality of life.

Care systems based on a QAPI philosophy is to ensure a systematic, comprehensive, data-driven approach to care. The approach may prevent adverse events, promote safety and quality, and reduce risks to residents and caregivers.


QA and PI combine to form QAPI, a comprehensive approach to ensuring high quality care. QAPI is a data-driven, proactive approach to improving the quality of life, care, and services in nursing homes. The activities of QAPI involve members at all levels of the organization to:

  • Identify opportunities for improvement
  • Address gaps in systems or processes
  • Develop and implement an improvement or corrective plan
  • Continuously monitor effectiveness of interventions

QAPI Features

QAPI includes components that emphasize improvements that can elevate the care and experience of all residents, and improve the work environment for caregivers. With QAPI, your organization will use a systems approach to actively pursue quality, not just respond to external requirements. Look at the following list of QAPI features and assess how many you are already implementing:

  • Using data to not only identify your quality problems, but to also identify other opportunities for improvement, and then setting priorities for action
  • Building on residents’ own goals for health, quality of life, and daily activities
  • Bringing meaningful resident and family voices into setting goals and evaluating progress
  • Incorporating caregivers broadly in a shared QAPI mission
  • Developing Performance Improvement Project (PIP) teams with specific “charters”
  • Performing a Root Cause Analysis to get to the heart of the reason for a problem
  • Undertaking systemic change to eliminate problems at the source
  • Developing a feedback and monitoring system to sustain continuous improvement

QAPI and Nursing Home Quality Care Collaborative Learning

The Nursing Home Quality Care Collaborative Learning series has QI and QAPI focused tracks that guides nursing homes through meeting their QI responsibilities in ways that maximize the benefits of QAPI principles. Please go to Nursing Home Quality Care Collaborative Learning for highlights, recordings, tools, materials, resources, and a myriad of topics including operationalzing QAPI, engaging residents in QI, how to implement proven QI programs, how to spread and scale improvement and much more.

Links below will feature more about the QAPI topic and useful tools.


Cardiovascular Health
Cardiovascular Health (DC)
Cardiovascular Health (NY)
Cardiovascular Health (SC)
Care Coordination
Care Coordination DC
Care Coordination NY
Beneficiaries and Families
Healthcare Professionals
Other Website Resources
Tools and Resources
Past Success
Upcoming Events
Past Events
Contact Us
Care Coordination SC
Community Based Sepsis
Educational Webinar Programs
Sepsis in the News
Tools and Resources
Diabetes Self-Management
EDC Foot Care Campaign
Diabetes Self-Management Education (DC)
Diabetes Self-Management Education (NY)
Drug Safety
Anticoagulation Safety
Hypoglycemia Avoidance
Opioid Safety
Opioid Safety (DC)
Opioid Safety in Community Pharmacy
Drug Safety (DC)
Drug Safety (NY)
Drug Safety (SC)
Immunization (DC)
Immunization (NY)
Immunization (SC)
SC Immunization Coalition Materials
Nursing Home Quality
Nursing Home Quality (NY)
QAPI Self-Assessment
Eliminating Inappropriate Antipsychotic Medication Use
Clinical Quality Measures (QM)
Composite Measure Score
NHQCC Collaborative I Kick-Off
NHQCC Collaborative I Outcomes Congress
Using a System's Approach to Quality & Performance Improvement
Nursing Home Quality Care Collaborative (NHQCC) Learning
Engaging Staff in Individualized Care
QAPI Self-Assessment and Related Resources
QAPI In Action
Quality Improvement (QI) Resources
Quality Improvement Strategies
Steps to QAPI
Elements for Framing QAPI in Nursing Homes
Clinical Topics
Medication Use Tools & Resources
Pressure Ulcer Clinical Tools & Resources
Restraint Clinical Tools & Resources
Falls with Major Injuries
Health Care Acquired Conditions
Eliminating Long Term Care Re-Admissions Tools & Resources
Nursing Home Quality (DC)
Nursing Home Quality (SC)
ACE e-Newsletter
Clinical Topics
Organizational Change
Presentations and Handouts
Upcoming Events
Outpatient Antibiotic Stewardship
Core Element One: Commitment
Core Element Two: Action for Policy and Practice
Core Element Three: Tracking and Reporting
Core Element Four: Education and Expertise
Quality Payment Program
QPP Support for Large Practices
QPP Support for Small Practices
CMS Webinars & Programs
Request Free Technical Assistance
QPP Education
QPP General Information
Quality Measures
Improvement Activities (IA)
Promoting Interoperability (PI)
Transforming End of Life

Contact Us

New York

Pauline Kinney, RN, MA, LNHA, RAC-CT
Senior Director, Health Care Quality Improvement
Tel: (516) 209-5402
Fax: (516) 326-0434

Maureen Valvo, RN, BSN, RAC-CT
Senior Quality Improvement Specialist
Tel: (516) 209-5308

David L. Johnson, NHA, RAC-CT
Senior Quality Improvement Specialist
Tel: (518) 320-3516

Dan Yuricic, MA
Senior Quality Improvement Specialist
Tel: (516) 209-5458

IPRO Nursing Home Team