# QAPI

> QAPI (quality assurance and performance improvement) is the quality program CMS requires. Providers use data to track harm and fix root causes.

Source: https://incidentkit.ai/glossary/qapi · Updated Oct 5, 2026

Also known as: quality assurance and performance improvement, QAPI program, QAPI/QAA

## What QAPI is

QAPI is an ongoing program that runs on data. It is not one committee or one report. CMS's nursing home guide lists five parts:

1. Design and scope
2. Governance and leadership
3. Feedback, data systems and monitoring, including adverse events
4. Performance improvement projects
5. Systematic analysis and systemic action, including root cause analysis

## Where it is required

| Setting | Rule | Key point |
| --- | --- | --- |
| Hospitals | 42 CFR 482.21 | Track adverse patient events. Run improvement projects |
| Surgery centers | 42 CFR 416.43 (condition for coverage) | Write down each project's reason and results |
| Nursing homes | 42 CFR 483.75 | The QAA committee meets at least each quarter. One project a year on a high-risk area |
| Hospices | 42 CFR 418.58 | Track adverse patient events. Record projects and progress |
| Home health agencies | 42 CFR 484.65 | Run improvement projects |

Mix-up: QAPI is the program. The [QAA committee](https://incidentkit.ai/glossary/qaa-committee) is the nursing home group that oversees it. Hospitals and surgery centers give oversight to the governing body.

## Frequently asked questions

### Is QAPI required for ambulatory surgery centers?

Yes. 42 CFR 416.43 is a condition for coverage. It requires a data-driven quality program, tracked adverse events, written improvement projects and governing body oversight.

### What are the five elements of QAPI?

Design and scope, leadership, data and feedback, improvement projects, and system-wide analysis and action. CMS's QAPI at a Glance guide describes each.

### What data should a QAPI program use?

Quality indicator data and adverse event data, including patient care data. Use it to watch safety, find improvements and check they last.

## Sources

- [CMS: QAPI at a Glance, a step-by-step guide for nursing homes](https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/QAPI/downloads/QAPIAtaGlance.pdf)
- [42 CFR 482.21: Hospital QAPI condition of participation](https://www.ecfr.gov/current/title-42/section-482.21)
- [42 CFR 416.43: ASC QAPI condition for coverage](https://www.ecfr.gov/current/title-42/section-416.43)
- [42 CFR 483.75: Nursing home QAPI](https://www.ecfr.gov/current/title-42/section-483.75)
- [42 CFR 418.58: Hospice QAPI condition of participation](https://www.ecfr.gov/current/title-42/section-418.58)
- [42 CFR 484.65: Home health agency QAPI condition of participation](https://www.ecfr.gov/current/title-42/section-484.65)

## Related terms

- [QAA committee](https://incidentkit.ai/glossary/qaa-committee)
- [Performance improvement project](https://incidentkit.ai/glossary/performance-improvement-project)
- [Root cause analysis](https://incidentkit.ai/glossary/root-cause-analysis)
- [Adverse event](https://incidentkit.ai/glossary/adverse-event)
- [Effectiveness review](https://incidentkit.ai/glossary/effectiveness-review)

## Related

- [QAPI program guide for ASCs, nursing homes and hospitals](https://incidentkit.ai/guides/qapi-program-guide)
- [ASC QAPI requirements: 42 CFR 416.43 explained](https://incidentkit.ai/compliance/cms-qapi/ambulatory-surgery-centers)
- [Nursing home QAPI requirements: 42 CFR 483.75 explained](https://incidentkit.ai/compliance/cms-qapi/skilled-nursing-facilities)
- [Hospital QAPI requirements: 42 CFR 482.21 explained](https://incidentkit.ai/compliance/cms-qapi/hospitals)
- [Hospice QAPI requirements: 42 CFR 418.58 explained](https://incidentkit.ai/compliance/cms-qapi/hospice)
- [Home health QAPI requirements: 42 CFR 484.65 guide](https://incidentkit.ai/compliance/cms-qapi/home-health)
- [QAPI Committee Meetings: Agenda, Data and Minutes](https://incidentkit.ai/use-cases/qapi-committee-meetings)