The Quality Improvement Program for Missouri’s Long-Term Care Facilities (QIPMO) will send gerontologic nurse specialists to Missouri nursing facilities. They will provide information and assistance related to clinical issues of interest to long-term care staff. QIPMO is a cooperative program between the MU Sinclair School of Nursing and the Missouri Department of Health and Senior Services (DHSS) with funding by DHSS using the Missouri Quality of Care fund (Senate bill 556). QIPMO nurses are not surveyors from the Department of Health and Senior Services. The site visits are treated confidentially.

If your facility is in Missouri, QIPMO nurse consultants will help refine your quality improvement programs. Members of the QIPMO team can also help you learn to download, read, and interpret your state and federal MDS quarterly reports and help simplify the quarterly MDS data. The nurses can also provide clinical practice consultations and in-service training sessions for your staff to help improve nursing care in those areas where you would like to see improvement.

Advance directives in the nursing home setting: an initiative to increase completion and reduce potentially avoidable hospitalizations

Published On: 01-01-2021

Written By: Galambos, C., Rantz, M., Popejoy, L., Ge, B., & Petroski, G.

Advance directive (AD) completion can improve transitions between hospitals and skilled nursing facilities (SNF’s). One Centers for Medicare and Medicaid Services (CMS) Innovations Demonstration Project, The Missouri Quality Initiative (MOQI), focused on improving AD documentation and use in sixteen...

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A coordinated response to the COVID-19 pandemic in Missouri nursing homes

Published On: 07-01-2020

Written By: Popejoy, L., Vogelsmeier, A., Boren, W., Martin, N., Kist, S, Canada, S., Miller, S.J., & Rantz, M.

In the United States, the first case of the novel coronavirus 2019 (COVID-19) was detected in January 2020 in the state of Washington. By February 2020, COVID-19 was linked to 167 confirmed cases of staff and residents within a...

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Impact of Survey Readiness Training on Nursing Home Quality of Care

Published On: 11-01-2018

Written By: Phillips, L.J., Oyewusi, C., Martin, C., Youse, E., & Rantz, M.J.

Due to their role overseeing administrative, operational, and clinical services in nursing homes (NHs), licensed nursing home administrators (LNHAs) are responsible for quality of care and correcting deficiencies identified during the annual certification and survey process. State regulations vary...

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Analysis of advance directive documentation to support palliative care activities in nursing homes

Published On: 11-20-2016

Written By: Galambos, C., Starr, J., Rantz, M., & Petroski, G.

As part of an intervention to improve health care in nursing homes with the goal of reducing potentially avoidable hospital admissions, 1,877 resident records were reviewed for advance directive (AD) documentation. At the initial phases of the intervention, 50...

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Better care, better quality: reducing avoidable hospitalizations of nursing home residents

Published On: 10-01-2015

Written By: Rantz, M.J., Flesner, M.K., Franklin, J., Galambos, C., Pudlowski, J., Pritchett, A., Alexander, G., & Lueckenotte, A.

The MOQI Intervention Model illustrates the key components of the intervention. An APRN guides the intervention delivering care to the residents and training the facility staff to improve their skills. An MOQI intervention team assists with medical care, care...

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Integrating advanced practice registered nurses into nursing homes: The Missouri Quality Initiative experience

Published On: 04-01-2015

Written By: Vogelsmeier, A., Popejoy, L., Rantz, M., Flesner, M., Lueckenotte, A., & Alexander, G.

There are nearly 1.5 million older adults residing in nursing homes (NH) across the United States. Reducing avoidable hospitalizations among vulnerable NH residents has become a national priority. Estimates suggest more than $14 billion of Medicare funding is spent annually on hospitalizations for this vulnerable population....

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Staff perceptions of social work student contributions to home health care services at an independent living facility

Published On: 04-01-2015

Written By: Galambos, C., Starr, J., Musterman, K., & Rantz, M.

This exploratory qualitative study examined staff perceptions of social work student contributions to client services, family and client communication, and staff workload in an independent living setting for older adults. Ten employees who had contact with the students, clients...

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Certified nurse aide scope of practice

Published On: 01-01-2015

Written By: Siem, C. & Rantz, M.

Editorial Siem, C. & Rantz, M. (2015). Certified nurse aide scope of practice. Journal of the American Medical Directors Association, 16(1), 6.

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Impact of nurse practitioners on health outcomes of Medicare and Medicaid patients

Published On: 11-01-2014

Written By: Oliver, G.M., Pennington, L., Revelle, S., & Rantz, M.

Strengthening healthcare overall is essential to the health of our nation and promoting access to healthcare as well as controlling healthcare costs in a quality cost-effective manner. Nurse practitioners have demonstrated in prior research to be effective and cost-effective...

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QIPMO Video

Published On: 06-19-2014

Written By: Strata Commun

Wonder what QIPMO is all about? Click here for a quick and informative video! Strata Commun

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Initiative to test a multidisciplinary model with advanced practice nurses to reduce avoidable hospitalizations among nursing facility residents

Published On: 02-04-2014

Written By: Rantz, M., Alexander, G., Galambos, C., Vogelsmeier, A., Popejoy, L., Flesner, M., Lueckenotte, A., Crecelius, C., & Zwygart-Stauffacher, M.

Consider the current reality for Mrs. Florence Jones, a woman of advanced age and mild dementia in a long-term care facility, who insists everyone call her “Flossie”: On May 1, Karen, the nurse aide taking care of Flossie, needs...

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The influence of teams to sustain quality improvement in nursing homes that “need improvement”

Published On: 01-01-2013

Written By: Rantz, M.J., Zwygart-Stauffacher, M., Flesner, M., Hicks, L., Mehr, D., Russell, T., & Minner, D.

Objectives: Qualitatively describe the use of team and group processes in intervention facilities participating in a study targeted to improve quality of care in nursing homes “in need of improvement.” Design/setting/participants: A randomized, two-group, repeated-measures design was used to...

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Challenges of using quality improvement methods in nursing homes that “need improvement”

Published On: 10-01-2012

Written By: Rantz, M.J., Zwygart-Stauffacher, M., Flesner, M., Hicks, L., Mehr, D., Russell, T., & Minner, D.

Objectives: Qualitatively describe the adoption of strategies and challenges experienced by intervention facilities participating in a study targeted to improve quality of care in nursing homes “in need of improvement”. To describe how staff use federal quality indicator/quality measure...

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Randomized multilevel intervention to improve outcomes of residents in nursing homes in need of improvement

Published On: 01-01-2012

Written By: Rantz, M.J., Zwygart-Stauffacher, M., Hicks, L., Mehr, D., Flesner, M., Petroski, G.F., Madsen, R.W., & Scott-Cawiezell, J.

Objectives: A comprehensive multilevel intervention was tested to build organizational capacity to create and sustain improvement in quality of care and subsequently improve resident outcomes in nursing homes in need of improvement. Design/Setting/Participants: Intervention facilities (N ¼ 29) received...

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Improving care in nursing homes using quality measures/indicators and complexity science

Published On: 01-01-2010

Written By: Rantz, M.J., Flesner, M.K., Zwygart-Stauffacher, M.

The authors report on a NIH multilevel intervention study (n=58; 29 intervention, 29 control) performed in a Midwestern state over a 2 year time frame. Complexity science was the theoretical model used to analyze the observations made by research...

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Helping nursing homes “at risk” for quality problems: a statewide evaluation

Published On: 07-01-2009

Written By: Rantz, M.J., Cheshire, D., Flesner, M., Petroski, G.F., Hicks, L., Alexander, G., Aud, M.A., Siem, C., Nguyen, K., Boland, C., & Thomas, S.

Nearly everyone has some life experiences or opinions based on media about nursing homes and the need for quality improvement. States and federal agencies spend enormous amounts of time regulating and surveying nursing homes, but quality problems persist. In...

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Care Improvement Program Saves Nursing Homes Millions

Published On: 05-14-2009

Written By: Medical News Today

Marilyn Rantz, professor in the MU Sinclair School of Nursing completed a three-year analysis of the Quality Improvement Program of Missouri (QIPMO) and found significant improvements in overall care quality of residents in participating facilities. Care Improvement Program Saves...

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Improvements in Missouri Nursing Homes Using QIPMO Services

Published On: 07-01-2008

Written By: Interdisciplinary Center on Aging

Improvements in Missouri Nursing Homes Using QIPMO Services – Interdisciplinary Center on Aging (2008) The Quality Improvement Program for Missouri (QIPMO) is a cooperative service of the University of Missouri Sinclair School of Nursing and the Missouri Department of Health...

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Entrepreneurial program of research and service to improve nursing home care

Published On: 12-01-2006

Written By: Rantz, M., Mehr, D., Hicks, L., Scott-Cawiezell, J., Petroski, G.F., Madsen, R.W., Porter, R., & Zwygart-Stauffacher, M.

This is a methodological article intended to demonstrate the integration of multiple goals, multiple projects with diverse foci, and multiple funding sources to develop an entrepreneurial program of research and service to directly affect and improve the quality of...

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Field testing, refinement and psychometric evaluation of a new measure of nursing home care quality

Published On: 02-17-2006

Written By: Rantz, M., Zwygart-Stauffacher, M., Mehr, D., Petroski, G., Owen, S., & Madsen, R

The primary aim of this NINR-NIH-funded field test in 407 nursing homes in 3 states was to complete the development of and conduct psychometric testing for the Observable Indicators of Nursing Home Care Quality Instrument (Observable Indicators, OIQ). The...

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Advances in measuring quality of care in nursing homes: a new tool for providers, consumers, regulators, and researchers

Published On: 10-01-2005

Written By: Rantz, M.J., Zwygart-Stauffacher, M., & Flesner, M.

Over the past 12 years, members of the Minimum Data Set (MDS) and Quality Research Team at the University of Missouri-Columbia have been working with the Missouri Department of Health and Senior Services to improve care in Missouri nursing...

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Back to the fundamentals of care: A road map to improve nursing home care quality

Published On: 04-01-2004

Written By: Rantz, M.J. & Zwygart-Stauffacher, M.

Rantz, M.J., & Zwygart-Stauffacher, M. (2004). Back to the fundamentals of care: A road map to improve nursing home care quality. Journal of Nursing Care Quality, 19(2), 92-94.

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Nursing home quality and pressure ulcer prevention and management strategies

Published On: 04-01-2004

Written By: Wipke-Tevis, D.D., Williams, D.A., Rantz, M.J., Popejoy, L.L., Madsen, R.W., Petroski, G.F., & Vogelsmeier, A.A

OBJECTIVES: To measure pressure ulcer quality indicator (QI) scores and to describe the self-reported skin integrity assessment, pressure ulcer risk assessment, and pressure ulcer prevention and treatment practices in long-term care facilities (LTCFs). DESIGN: Retrospective analysis of a large data set...

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Nursing home quality, cost, staffing, and staff-mix

Published On: 02-01-2004

Written By: Rantz, M.J., Hicks, L., Grando, V.T., Petroski, G.F., Madsen, R.W., Mehr, D.R., Conn, V., Zwygart-Stauffacher, M., Scott, J., Flesner, M., Bostick, J., Porter, R., & Maas, M.

The purpose of this study was to describe the processes of care, organizational attributes, cost of care, staffing level, and staff mix in a sample of Missouri homes with good, average, and poor resident outcomes. In facilities with good...

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Stability and sensitivity of nursing home quality indicators

Published On: 01-01-2004

Written By: Rantz, M.J., Hicks, L. Petroski, G.F., Madsen, R.W., Mehr, D.R., Conn, V., Zwygart-Stauffacher, M., & Mass, M.

The issues of stability and sensitivity of indicators to actually detect differences in quality of care in nursing facilities are not only of concern to researchers, but also to public policy makers, who are reporting indicators to providers and...

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A statewide strategy to improve quality of care in nursing facilities

Published On: 04-01-2003

Written By: Rantz, M.J., Vogelsmeier, A., Manion, P., Minner, D., Markway, B., Conn, V., Aud, M.A., & Mehr, D.R.

We describe the development of a statewide strategy to improve resident outcomes in nursing facilities, and we present some evaluative data from this strategy. Key components of the strategy include (a) a partnership between the state agency responsible for...

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Randomized clinical trial of a quality improvement intervention in nursing homes

Published On: 08-01-2001

Written By: Rantz, M.J., Popejoy, L, Petroski, G.F., Madsen, R.W., Mehr, D.R., Zwygart-Stauffacher, M., Hicks, L.L., Grando, V., Wipke-Tevis, D.D., Bostick, J., Porter, R., Conn, V.S., & Maas, M.

Purpose: The purpose of the study was to determine if simply providing nursing facilities with comparative quality performance information and education about quality improvement would improve clinical practices and subsequently improve resident outcomes, or if a stronger intervention, expert clinical...

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Improving quality of care in nursing facilities: The gerontological clinical nurse specialist as research nurse consultant

Published On: 04-01-2000

Written By: Popejoy, L.L., Rantz, M.J., Conn, V., Wipke-Tevis, D., Grando, V., & Porter, R.

It is becoming increasingly common for nursing facilities to use Quality Indicators (QI) derived from Minimum Data Set (MDS) data for quality improvement initiatives within their facilities. It is not known how much support facilities need to effectively review...

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Setting thresholds for MDS quality indicators for nursing home quality improvement reports

Published On: 12-01-1997

Written By: Rantz, M. J., Petroski, G.F., Madsen, R.W., Scott, J., Mehr, D., Popejoy, L., Hicks, L., Porter, R., Zwygart-Stauffacher, M., & Grando, V.

An important area of inquiry in quality measurement when using quality indicators (QIs) lies in determining what thresholds indicate good and poor resident outcomes. In July 1996, a cross-section of 13 clinical care personnel from nursing homes participated on...

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Setting thresholds for quality indicators derived from MDS data for nursing home quality improvement reports: An update

Published On: 11-01-1997

Written By: Rantz, M. J., Petroski, G., Madsen, R., Mehr, D., Popejoy, L., Hicks, L., Porter, R., Zwygart-Stauffacher, M. & Grando, V

Determining meaningful thresholds to reinforce excellent performance and flag potential problem areas in nursing home care is critical for preparing reports for nursing homes to use in their quality improvement programs. This article builds on the work of an...

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Assessing contributors to cost of care in nursing homes

Published On: 07-01-1997

Written By: Hicks, L.L., Rantz, M. J., Petroski, G.F., Madsen, R.W., Conn, V.S., Mehr, D., & Porter, R.

In 1994 12.7% of the population was 65 and over, while 10.6% were 85 and over. Expenditures for nursing homes reached $72.3 billion in 1994 (much of which is tax-supported) accounting for 8.7% of all personal health money spent....

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