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Indiana State Department of Health

ISDH Home > Health Care Quality & Regulatory > Indiana Health Care Quality Resource Center > Quality Indicator Survey Resource Center Quality Indicator Survey Resource Center

Welcome to the Indiana State Department of Health (ISDH) Quality Indicator Survey Process Resource Center.  This Resource Center provides information, tools, and resources about the Quality Indicator Survey (QIS) Process.  The Quality Indicator Survey Process was developed by the Centers for Medicare and Medicaid Services (CMS) for the surveying of federally certified nursing homes.  Indiana will begin implementing the system in January 2011.  The ISDH expects the implementation to take two to three years for full implementation. 

The Quality Indicator Survey (QIS) which is a computer assisted long term care survey process used by State Survey Agencies and CMS to determine if Medicare and Medicaid certified nursing homes meet the Federal requirements.
The Quality Indicator Survey Process was designed to achieve several objectives:

  • Improve consistency and accuracy of quality of care and quality of life problem identification by using a more structured process;
  • Enable timely and effective feedback on survey processes for surveyors and managers;
  • Systematically review requirements and objectively investigate all triggered regulatory areas within current survey resources;
  • Provide tools for continuous improvement;
  • Enhance documentation by organizing survey findings through automation; and
  • Focus survey resources on facilities (and areas within facilities) with the largest number of  quality concerns.

Announcements / Current News

 

Contacts

Indiana State Department of Health
2 North Meridian Street
Indianapolis, IN 46204
(317) 233-1325 (ISDH Main Switchboard)
Map

Survey Manager
Division of Long Term Care
Brenda Buroker, RN
Indiana State Department of Health
Division of Long Term Care
2 North Meridian Street, 4-B
Indianapolis, IN 46204
Email: bburoker@isdh.in.gov
Phone: (317) 234-7340
Fax:  (317) 233-7322

Program Director
Health Care Education and Training Program
Gina Berkshire, RN
Indiana State Department of Health
Division of Long Term Care
2 North Meridian Street, 4-B
Indianapolis, IN 46204
Email: gberkshire@isdh.in.gov
Phone: (317) 233-7497
Fax:  (317) 233-7322

Definitions and Acronyms

Acronyms used on this web site: 

  • ASPEN – Automated Survey Processing Environment
  • ACO – ASPEN Central Office
  • ASE – ASPEN Survey Explorer
  • CEs – Critical Element Pathways
  • CMS - Centers for Medicare and Medicaid Services
  • ISDH - Indiana State Department of Health 
  • PSR - Post Survey Revisit
  • QAPI - Quality Assessment / Process Improvement
  • QIS - Quality Indicator Survey
  • QIS DCT – Quality Indicator Survey Data Collection Tool
  • QCI – Quality of Care Indicators

Glossary:

A comprehensive list of acronyms and definitions used in the Quality Indicator Survey Process may be found in the QIS Manual at the link below. 

Description of Quality Indicator Survey Process

CMS Survey and Certification Letter 08-21 (May 16, 2008):  Updated Brochure Describing the Quality Indicator Survey

This letter includes a brochure that provides a brief description of the QIS and an overview of the  QIS training process.  The brochure includes charts showing a description of the QIS process and  a comparison between traditional and QIS surveys.

CMS Survey and Certification Letter 09-50 (April 7, 2009) – Priority Order of Quality Indicator Survey (QIS) National Implementation in States

This Survey Letter provided information on QIS implementation to include the priority order for  states and information on state preparation to QIS implementation.

CMS Survey and Certification Letter 08-14 (March 21, 2008):  Federal Minimum Qualification Standards for Long Term Care Registered Quality Indicator Survey Surveyors and CMS-Certified QIS Trainers for State Implementing the QIS Process

This CMS Letter provides Federal minimum standards for training surveyors and trainers in the QIS. These standards are intended to assure effective and consistent QIS implementation for the training of State and Federal surveyors and their trainers in the Federal QIS process.

CMS Survey and Certification Letter 09-46 (June 2009) – Release of Report “Evaluation of the Quality Indicator Survey (QIS)”

The Survey Letter provides the “Evaluation of the Quality Indicator Survey (QIS)” report and outlines an action plan for future QIS evaluation initiatives.

CMS Survey and Certification Letter 11-25-NH/QIS (August 5, 2011) - Clarification of Quality Indicator Survey (QIS) Team Size

This CMS letter provides guidance to State Agencies (SA) on how to determine survey team size when conducting a QIS survey in facilities with forty (40) certified beds or less. 

Frequently Asked Questions

QIS Process Questions and Answers

Implementation

The overall planned timeline for the implementation of the Quality Indicator Survey Project is as follows:

  • 2005:  CMS launched QIS Demonstration Project
  • 2006 –August 2009:  CMS began training in 11 states
  • August 2009:  CMS issued survey letter indicating implementation timeline for remaining states
  • August 2, 2010:  ISDH participated in CMS Information Call on initial preparations for QIS implementation
  • November 2010:  ISDH began scheduling and preparations for QIS training
  • January 2011:  Training of first two ISDH QIS teams begins
  • April 2011:  Training of first two ISDH QIS teams completed
  • April 2011:  Training of ISDH QIS Trainer completed
  • May 2011:  Ongoing training begins for all long term care surveyors
  • November 2012:  QIS training completed for all long term care surveyors

Links to Related Organizations and Agencies

Nursing Home Quality LLC, Centennial, CO

Nursing Home Quality is serving as the national project manager for the QIS project. 

University of Colorado, Health Care Policy & Research Program 

The University of Colorado was responsible for the development of the QIS training process.

Link to Centers for Medicare and Medicaid Services

Centers for Medicare and Medicaid Services Home Page

Quality Indicator Survey Materials: Forms, Guides, and Memos

QIS Forms, Guides, Information, and Memos

This links to the QIES Technical Support Office QIS Site providing comprehensive access to QIS  forms, guides, information, and memos. 

QIS Resource Manual

This links to the University of Colorado Health Care Policy and Research Program who worked on development of the QIS process.  The site provides the complete QIS Resource Manual. 

CMS QIS Video for Surveyors and Certification Specialists

This site links to the CMS Survey and Certification Group’s video on the QIS process.  The goal of the broadcast was to increase participant understanding of the QIS process for surveying  nursing homes. 

QIS Information to Support States Preparing for QIS Training and Implementation

This Powerpoint is from July 2010 CMS Conference Call with Indiana and other states to provide information on the QIS training and implementation process.

State Survey Agency Implementation of the Quality Indicator Survey (QIS)

This Powerpoint is from the December 13, 2010 QIS Conference Call.  The Call was provided for Indiana nursing homes as an overview of the QIS implementation process for Indiana. 

Regulations

The CMS State Operations Manual provides the survey process for the federal health care facility certification program.  Although the survey process has been revised under the QIS, the Federal regulations and interpretive guidance remain unchanged.  The QIS Manual will indicate the changes in the survey process. 

CMS State Operations Manual Appendix P:  Survey Protocol for Long Term Care Facilities.

State Operations Manual  Appendix P (Survey Protocols)

CMS State Operations Manual Appendix PP:  Guidance to Surveyors for Long Term Care Facilities.

State Operations Manual  Appendix PP (Guidance to Surveyors)

Resources / Toolkits