Quality Indicator Survey Operational Support and Analysis

Project Overview

For this project, Insight provides operational support and analysis for the Quality Indicator Survey (QIS). The Centers for Medicare and Medicaid Services (CMS) first implemented the QIS in 2007 to determine if Medicare- and Medicaid-certified nursing homes meet Federal requirements. The computer-based survey is used in 27 States and the District of Columbia.

The objectives of the QIS are to:

  • Improve consistency and accuracy of quality of care and quality of life problem identification.
  • Enable timely and effective feedback on survey processes for surveyors and managers.
  • Systematically review reporting requirements and objectively investigate all triggered regulatory areas.
  • Provide tools for surveyors.
  • Facilitate transition to a paperless survey process.
  • Focus survey resources on facilities (and areas within facilities) with the largest number of quality concerns.

Under contract with CMS, Insight, in collaboration with the University of Colorado Denver (UC Denver) School of Medicine, is working on national implementation and continuous improvement of the QIS in an effort to ensure quality of care in nursing homes. Our combined team of QIS experts:

  • Train survey teams from State and regional offices.
  • Respond to help desk inquiries related to the QIS.
  • Critically review and analyze proposed regulatory changes for impacts to the QIS.

Insight oversees project management for QIS support and collaborates closely with the UC Denver and CMS to determine appropriate sampling procedures in nursing homes of varying sizes, as well as determine the threshold levels that when exceeded trigger citations that may alert CMS to safety and quality of life issues. This analysis determines the citation issuance rate. This citation rate provides CMS with feedback on nursing home performance in areas of safety and quality of care. The goal of this analysis is to increase valid citation rates and reduce unnecessary survey investigations.

Core Activities

Project Management; Survey Instrument Testing and Redesign; Training and Technical Assistance; Sampling Procedures; Data Collection


  • Training materials for State QIS
  • Memoranda to CMS summarizing survey changes
  • List of frequently asked questions and their answers for publication on the QIS Web site