Stage I and Stage II of the QIS
We’ve learned that the Quality Indicator Survey (QIS) is a two-stage process used by surveyors to systematically review specific nursing home requirements and objectively investigate any regulatory areas that are triggered. Stage I of the process is a preliminary investigation, whereas Stage II is a more in-depth investigation culminating with analysis and decision to cite or not.
Here is a brief description of each stage:
Stage I
- Initial review of the sample of residents which includes resident, family, and staff interviews; resident observations; and clinical reviews.
- Utilizing the surveyors’ tablet PCs, the results of these preliminary investigations are combined to provide a comprehensive set of Quality of Care and Quality of Life Indicators (QCLIs) for use in Stage II.
- Mandatory facility-level tasks are started including resident council president interview; observations of dining and kitchen areas, infection control practices, and medication administration; review of the Medicare demand billing process and the QA program.
- A computerized tool uses the surveyor’s findings together with MDS data to determine which QCLIs exceed national thresholds and consequently triggers care areas and/or trigger facility-level tasks for further investigation in Stage II.
Stage II
- Investigation of triggered care areas.
- Completion of mandatory facility-level tasks.
- Investigation of triggered facility-level tasks which include abuse prohibition, environment, nursing services, sufficient staffing, personal funds, and admission, transfer and discharge.
Similar to the traditional survey, the team analyzes the results and an exit conference is conducted, during which the nursing home is informed of the survey findings.
Coming Next: QIS Resources and Tips for Providers
Author: Kathy Pellatt, EQUIP Lead Quality Improvement Analyst