State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report

APPENDIX E. Provider Training Programs


Teaching Nursing Home Program
Educational Materials
Conference Calendar


Florida's Teaching Nursing Home Program1

Florida's Teaching Nursing Home (TNH) Program was created in 1999 via legislative House Bill 1971 and was funded in 2000 to establish an integrated long term care (LTC) training curriculum for physicians and initiate an online geriatrics university. The TNH program is under the direction of Bernard Roos, MD, Director of the Stein Gerontological Institute at the Miami Jewish Home & Hospital for the Aged.

The TNH program is committed to integrated systems and to linking LTC resources and other community-based healthcare assets with professional and academic talents throughout our state. The TNH program has already established productive working relationships with several major nursing homes, with each of Florida's medical schools, and with several nursing schools.

Mission: Forging a more integrated and patient-centered LTC system through a comprehensive multidisciplinary statewide program of excellence in geriatrics training and research related to best practices and standards of care.


  1. Create and promote multidisciplinary education and research in LTC.

  2. Research, implement, and disseminate "best practices" for targeted LTC concerns.

  3. Enhance awareness and image of the LTC continuum, including community-based services.

  4. Initiate a dynamic process of statewide standardization of LTC that promotes and protects the interests of care recipients and providers.

Strategy: Provide forums, initiative, and core resources for identification and prioritization of LTC issues promote research and training in relevant best LTC practices and their adoption by communities and their entire range of health-care providers.

  1. Promote synergistic quality improvement in LTC through linking the concerns and activities of academia, industry, professional organizations, and public interest and advocacy groups.

  2. Create online forum resources and networks to promote needs assessments and to support training and best practices that address LTC concerns raised in communities throughout our state.

  3. Assist in care and training initiatives/models for community-identified LTC needs.

  4. Respond to LTC training and research needs of professionals, regulators, and emerging legislation.

  5. Develop multidisciplinary models to support quality improvement across LTC's continuum.


Educational Materials2

Below are several educational materials developed by the MU MDS and Quality Research Team, the Statewide Planning Committee for Improving MDS Assessment and Use, and the Quality Improvement Program for Missouri. All of these documents are in Adobe Portable Document Format (PDF), therefore you will need Adobe Acrobat Reader to view and print the documents. You can download the free Adobe Acrobat Reader at We hope you put these materials to good use.

The Resident Assessment Instrument

  1. Item by Item

    The MDS Version 2.0 Item by Item Quick Reference and Self Study Guide interprets each item on the MDS by giving a written detailed description along side many of the MDS items. The Item by Item guide also explains the standard coding conventions, timetables for submission, and other valuable information you will need when completing the MDS. In addition, the PPS supplement illuminates the mysteries of PPS. The appendix gives you additional resources and contact information.

    The Item by Item can be downloaded in 3 parts.

    Item by Item
    PPS Supplement

  2. Case Study

    The Case Study is a two-part scenario that takes you through the MDS, RAP triggers, RAP documentation, and care plans for a sample nursing home resident. Part One is a resident's initial admission to the nursing home while Part Two is a significant change in status resulting in a hospital stay and Medicare return admission. The Case Study is a valuable document for anyone practicing in Long-Term Care.

    Download the Case Study

  3. Self-Study Modules

    The Self-Study Modules present an overview of the entire Resident Assessment Process (RAI) with emphasis on the Resident Assessment Protocols (RAPs) and care planning process based on the RAI. The modules are organized so that you can learn at your own pace. If you are struggling with care plan or RAP issues, or are working with staff in need of RAI education, the Self-Study Modules can help.

    Download the Self-Study Modules

Quality Indicator (QI) Reports

  1. Show-Me QI Report User's Guide

    The "Show-Me" QI Reports are available to all nursing homes in Missouri submitting MDS data to the state database. These QI reports differ from the federal reports that facilities have access to nationwide. The "Show-Me" QI Reports show 5 quarters of data, allowing facilities to track their QIs over time. In addition, the "Show-Me" Reports have expert set thresholds for use to compare your specific facility QI data. The "Show-Me" QI Report User's Guide explains how to download and use your Missouri "Show-Me" QI reports.

    Download the Show-Me QI Report User's Guide

  2. Sample "Show-Me" QI Report

    Download a sample page from a "Show-Me" QI Report to see how it looks

    Download the Sample "Show-Me" QI Report

  3. List of Thresholds

    Here is a complete listing of the expert set QI thresholds used on the "Show-Me" Reports. We hope these thresholds help you determine potential problem areas when compared with your facility QI scores so that improvement in resident care and outcomes may occur.

    Download the complete List of Thresholds

Other Educational Tools

  1. Video Post-Test

    Mary Zwygart-Stauffacher, PhD, RN, CS, GNP/GCNS presented a workshop entitled "Prevention and Detection of Acute Clinical Problems in Older Adults" in the fall of 2001. The workshop was videotaped, professionally edited and distributed FREE to long-term care facilities in Missouri. Unfortunately, there are no more videos. However, for those facilities that did receive a video, the Quality Improvement Program for Missouri has developed a post-test to test your knowledge after viewing the video.

    Download the Video Post-Test

Copyright (c) 2003
MU MDS and Quality Research Team & the Curators of the University of Missouri
DMCA and other copyright information
Published by: Susan Farrell and Steven Miller


Conference Calendar3

Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec

Organizations that sponsor LTC educational events and that wish to have their scheduled conferences listed in this calendar should send an email to the QM Webmaster. Please include the title of your conference, a link to your conference web page if you have one, the name of the sponsoring organization, and the date and the location of the conference.

A separate calendar of DHS Joint Training events for providers and surveyors is available on the LTC-R Web.

January 2003

February 2003

March 2003

April 2003

May 2003

June 2003

July 2003

August 2003

September 2003

October 2003

November 2003

December 2003

Last updated: January 27, 2003


  1. Source:, 5/12/2003.

  2. Source:, 4/1/2003.

  3. Source:, 4/23/2003.

Return to:
  • Table of Contents
  • APPENDIX A. State Reports
  • APPENDIX B. Public Reporting Systems
  • APPENDIX C. Technical Assistance Programs
  • APPENDIX D. Best Practices
  • You can also advance to:
  • APPENDIX F. Facility Recognition Programs
  • APPENDIX G. Funding of Quality Improvement Programs