10/01/2026

Survey Tip of the Week: QAPI Priorities

Under §483.75(e)(1), facilities must set priorities for its performance improvement activities that focus on high-risk, high-volume, or problem-prone areas; consider the incidence, prevalence, and severity of problems in those areas. Priorities should also address areas affecting resident outcomes, safety, autonomy, choice, and quality of care. CMS provides the following definitions:

• High-risk areas: Care or service areas associated with significant risk to the health or safety of residents. Errors in these care areas have the potential to cause adverse events resulting in pain, suffering, and/or death. Examples include tracheostomy care; pressure injury prevention; administration of high-risk medications such as anticoagulants, insulin, and opioids.
• High-volume areas: Care or service areas performed frequently or affecting a large population, thus increasing the scope of the problem, e.g., transcription of orders; medication administration; laboratory testing.
• Problem-prone areas: Care or service areas that have historically had repeated problems, e.g., call-bell response times; staff turnover; lost laundry.

 Facility policies and procedures must address how data will be identified, and the frequency and methodology for collecting and using data from all departments. Additionally, facilities must also conduct distinct Performance Improvement Projects (PIPs) appropriate to the scope and complexity of their services and available resources, as reflected in the facility assessment required at §483.71. At least annually, the facility must conduct a PIP focused on a high-risk or problem-prone area identified through its own data collection and analysis.