Nebraska Implementing QIS Process

Nebraska is moving toward implementing the QIS (Quality Indicator Survey) process. Nebraska is part of the second group of states in which CMS is doing this, along with Colorado and New York. Nebraska will begin implementing the QIS process beginning August 2010.

Compared to the current, traditional, surveying system which has information documented on paper throughout the process, each CMS team member will use a tablet PC to document findings. These findings will then be electronically synthesized, organized and loaded to the CMS. When doing onsite preparation, QIS team members will analyze alphabetical resident censuses with room numbers and units in addition to a list of new admissions over the last thirty days. There will also be substantial changes to offsite preparation, the initial tour process, sample selection, and to various other aspects of the survey process.

QIS surveys will involve two stages. Each stage will involve three steps. Step one will be “computer generated sampling”. Step two will be “investigation”. Step three will be “synthesis”. The first stage will involve a preliminary investigation of regulatory areas. The second stage will involve an in-depth investigation into deficiencies identified in stage one.

This system will be implemented in phases across the state, using “teams” to do one area of the state at a time. This will take two to two and a half years to implement fully. Because it will be more objective, driven by MDS data, and feature large sample sizes it will likely result in a higher rate of deficiencies in place of many “FYI” comments surveyors presently give.

Jeanelle R. Lust