CMS Pub. 100-11, ch. 10, § 20

The PACE organization must develop, implement, maintain, and evaluate an effective

data-driven QAPI program. It is important that the QAPI program reflects the full range

of services furnished by the PACE organization. In developing the QAPI program, the

PACE organization should use organizational data to identify and improve areas of poor

performance. The PACE organization must take actions that result in improvements in its

performance in all types of care.

Currently, CMS does not require the use of a common quality assessment tool or a set of

specific outcome measures beyond the data elements for monitoring included in the

program agreement. PACE organizations have the flexibility to develop the QAPI

program that best meets their needs in order that they may fully meet the obligations of

care for its participants. It is CMS’s expectation that PACE organizations will operate a

continuous QAPI program that does not limit activity to only selected kinds of services or

types of patients. The desired outcome of the QAPI requirement is that data-driven

quality assessment serves as the engine that drives and prioritizes continuous

improvements for all the PACE organization’s services.

[42 CFR §§ 460 Preamble Discussion, 460.130; 71 FR 71305 (Dec. 8, 2006)]