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What's New (2011/09/21)


QIS Survey Menu

  1. QIS Survey Worksheets Links: Links to the QIS survey forms for offsite preparation, those required at entrance conference, mandatory facility task forms, triggered facility task forms, stage I forms and Critical Element pathway worksheets that will be part of the QIS survey process. The information is presented in a flow that outlines the QIS survey process.

    Benefits/Recommendations for use: It is recommended to review these forms stored and maintained by CMS on their QTSO website to become familiar with the process, prepare and know what to expect when the surveyors arrive. Many of these worksheets, especially the CE worksheets should be incorporated into the facility ongoing QA process to assure facility practices meet the standards of practice they will be evaluated against. It is advisable to minimally include the mandatory facility task forms and Critical Element Pathways worksheets into the facility QA program. It is not reasonable to review all of these every quarter but divide them into 4 quarters and cover all of them over the year. Choose some each month and when evaluating facility practices against these worksheets be sure that facility, policies and procedures are up to date, as well as, staff compliance. Family interviews should be conducted during weekly care conferences to be knowledgeable of family opinions and correct areas of concern. The entrance conference worksheet identifies the data facilities must provide on entrance of the surveyors (immediately, within 1 hour, within 4 hours, 24 hours). Knowing in advance gives facilities the opportunity to determine a process to quickly collect this data. Ability to quickly and accurately produce this data makes facilities appear well organized and managed.

  2. QIS Survey Resource Links: Links to resource tools including a map of State rollout dates, CQLI dictionary and the surveyor?s training manual.

    Benefits/Recommendations for use: It is recommended to review these reference materials maintained by CMS on their QTSO website to become familiar with the process, prepare and know what to expect when the surveyors arrive. Even if your state is not scheduled to convert to the QIS survey this year, it is never too early to incorporate these processes into a facilities QA program.

  3. QIS Resident Census Report: An alphabetical resident census with room numbers/units noting residents in census who are not in the facility (e.g., in the hospital, home visit, etc.) is required immediately at survey entrance.

    Benefits/Recommendations for use: To speed the provision of this information it can be printed directly from Pro-Tracking and will be as current as the data the facility has submitted. It is intended to print this report, add any additional new admits not already captured and then manually check the check boxes on the printed form if the resident is not in the facility.

  4. QIS New Admission Information Report: The facility is required to provide a list, immediately at survey entrance, of all new admissions for the 30 day period prior to the survey that still reside in the building. The list of new admissions must include admission date, DOB and room number and unit for each resident.

    Benefits/Recommendations for use: This form has been automated in Connections Performance Measurement to expedite the delivery of this information to the surveyors. The New Admission report will be as accurate as the data the facility has submitted. There are definitely benefits to sending transmission files timely.

  5. QIS PASRR II Screening Report: The PASRR II screening report is a part of the data that must be provided to surveyors within 4 hours of entrance to the facility. Surveyors are expecting a list of residents that triggered for PASRR screening and whether or not their diagnosis falls into MR or MI, including the source.

  6. Benefits/Recommendations for use: This report identifies residents that were PASRR screened on admission according to their MDS. The data from this report can be added to the Entrance Conference Worksheet provided by the surveyor. This is an easy source of identifying this group of residents.