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The Board of Directors' Role in the Hospice QAPI Program



The goal of this article is to highlight the important role that the Board of Directors has in a hospice QAPI program. Hospice QAPI is a detailed, overarching organizational program for the agency’s clinical and operational activities.

The goal of this article is to highlight the important role that the Board of Directors has in a hospice QAPI program. Hospice QAPI is a detailed, overarching organizational program for the agency’s clinical and operational activities.

  • Delivering high-quality care is becoming increasingly recognized as the responsibility of the entire organization, including the board. As payment structures and incentive plans in consideration of payment for quality evolve, the board should become more involved in the agency’s QAPI program.

  • The Board has specific responsibilities in the QAPI program per the Conditions of Participation:

  • Ensuring that an ongoing program for quality improvement and patient safety is defined, implemented, and maintained, and is evaluated annually.

  • Ensuring that the QAPI program reflects the complexity of its organization and services; involves all hospice services; focuses on indicators related to improved outcomes, approving frequency and detail of data collection; and takes actions to demonstrate improvement in performance.

  • Ensuring that the hospice-wide QAPI efforts address priorities for improved quality of care and patient safety, and that all improvement actions are evaluated for effectiveness.

  • Designating one or more individuals who are responsible for operating the QAPI program.

  • Review and approval of QAPI reports as communicated to the board.

  • Involvement in making decisions on the allocation of resources for performance improvement activities.

Hospice governing boards are facing a growing number of challenges, all of which are simultaneously converging to make organizational success more difficult. In order to be successful, trustees must not only understand their roles and responsibilities, but work diligently and forcefully to continually improve their leadership effectiveness and success.

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