Privilege for Quality Assurance Performance Improvement (QAPI) Documents and Reports
By:
David S. Barmak, JD
The Affordable Care Act (ACA) authorizes the Centers for Medicare & Medicaid Services (CMS) to establish and implement a Quality Assurance and Performance Improvement program for nursing facilities. This program focuses on improving quality of care and is known as QAPI. QAPI merges CMS’s Quality Assurance (QA) and Performance Improvement (PI) programs.
Regulations require nursing homes to develop, implement, and maintain an effective, comprehensive, data-driven QAPI program that focuses on indicators of the outcomes of care and quality of life. QAPI programs must be supported by documentation and evidence of program efforts and conducted in a certain manner to ensure privilege and confidentiality.
Nursing homes must have a Quality Assessment and Assurance (QAA) Committee. The QAA Committee must develop plans of action to correct deficiencies.
The QAA regulations provide that certain documents or reports created pursuant to a nursing home’s QAA program will be privileged and confidential (QAA Privilege). To be protected under the QAA Privilege, documents and reports created for use at a QAA Committee meeting must focus only on QAPI issues. The documents and reports should indicate that they are prepared for quality assurance purposes and they must analyze and evaluate quality of care. In addition, quality assurance discussions should be conducted during a formal QAA Committee meeting and documents should be kept confidential and marked as such.
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