Nursing Home Quality Improvement Initiatives

The Department of Public Health supports activities to protect, improve the quality of care, or improve the quality of life of nursing home residents through the Civil Monetary Penalties funding.

The Department of Public Health (DPH) is committed to improving the quality of services provided within all nursing homes and has worked on several key initiatives to provide assistance and resources for long term care facilities across Massachusetts.

Through the Centers for Medicare and Medicaid Services (CMS), Civil Monetary Penalty (CMP) funds provide Massachusetts with money to support activities to protect, improve the quality of care or improve the quality of life of nursing home residents. In order to promote transparency and ensure fairness, the Department will solicit proposals for the use of CMP funds using the state’s procurement process.

Visit the CMS website to learn more about the reinvestment of CMP funds and the projects supported by CMP funding in Massachusetts during the 2017 calendar year.

To learn more about the use of CMP funds, including information about project proposals, please visit the CMP Fund Project webpage.

Supportive Planning and Operations Team (SPOT)

The Supportive Planning and Operations Team (SPOT) Initiative provided technical assistance and training to staff of 60 participating Massachusetts nursing homes based upon their individual needs.

This Initiative supported nursing home teams in developing effective quality assurance and performance improvement (QAPI) programs. Effective QAPI programs can prevent adverse events, promote safety and quality, and reduce risks to residents and caregivers.

The SPOT Performance Improvement Project Workbook (DOC) is a guide for nursing homes when implementing quality improvement practices and includes handouts shared with participants at technical assistance visits.

  • Learn more about the 2016 SPOT Initiative project year, including the activities and results, in the SPOT Town Hall Stakeholder Presentation | (DOC).
  • Access resources and materials from the 2017 & 2018 SPOT Initiative project years below.

Materials from Year 3 of the SPOT Initiative

The SPOT team continues to work in Year 3 of the initiative to engage participating nursing homes throughout the Commonwealth. In 2018, nursing homes staff joined two in-person interactive sessions to learn key quality improvement strategies. A third learning session is scheduled for October.

In December 2018, the SPOT team hosted 2 stakeholder town hall presentations in Boston and Springfield to present the activities and results of the 2018 SPOT Initiative and highlight the work of select participating nursing home teams. Download the Boston stakeholder presentation slides or the Springfield stakeholder presentation slides to learn more about the 2018 SPOT Initiative.

Materials from Year 2 of the SPOT Initiative

In 2017, the SPOT team led 4 webinars for participating facilities. The slides from each webinar are available for download:

The SPOT team also provided participating facilities with worksheets to help with QAPI planning:

In January 2018, the SPOT team hosted 2 stakeholder town hall presentations in Boston and Springfield to present the activities and results of the 2017 SPOT Initiative. Download the stakeholder presentation slides to learn more about the SPOT Initiative Year 2.

Quality Assurance and Performance Improvement (QAPI) Resources for facilities

These resources were shared with long term care facilities that participated in Year 2 of the SPOT initiative. The links direct to the resources on the CMS, Agency for Healthcare Research and Quality (AHRQ), and Atom Alliance websites, and may help facilities as they develop a QAPI plan.

Past Projects

Since the inception of the CMP fund program, Massachusetts has funded a variety of projects to protect or improve the quality of care or quality of life of nursing home residents. Find resources below from some of the past CMP-funded projects.

  • Resident and Family Council Engagement Initiative: The Resident and Family Council Engagement Initiative worked with skilled nursing home staff, residents, and family members to develop, enhance, and sustain resident and family councils in their facilities. Click the link above to access presentations and resources from developed during this project.
  • Massachusetts Falls Prevention Coalition: The Massachusetts Falls Prevention Coalition was founded in 2006 to raise awareness among senior care providers and the public of the harmful impact of falls and the availability of successful prevention strategies. CMP funding was used to support the activities of the Coalition, including joint training for facility staff and surveyors from the Department on ways to reduce falls among nursing home residents. The work of the Coalition subsequently led in part to the establishment of the Massachusetts Commission on Falls Prevention and their 2013 Phase 1 Report PDF (DOC).
  • OASIS: With support from CMP funding, 363 Massachusetts nursing facilities enrolled in the initiative receive training and support to implement the innovative, non-pharmacologic focused OASIS curriculum, designed to help staff meet the needs of residents with dementia. This resident-centered approach to reducing antipsychotic medications focused on helping all nursing facility staff develop and refine behavioral strategies to improve quality of life for residents and job satisfaction for staff members.
  • Massachusetts Long Term Care Mutual Aide Plan (MassMAP): CMP funding provided support to nursing homes for participation in this program. MassMAP creates a system of support that provides participating facilities with resources and technical assistance in the event of a disaster; and conducts annual exercises to better prepare nursing homes to respond to a disaster and protect their resident.