Follow the steps to successfully fill out the CMS QAPI Worksheet_DSA online.

1. Press the ‘Get Form’ button to access the CMS QAPI Worksheet_DSA and open it in your designated editor.
2. Begin with Part 1, providing essential hospital characteristics. Fill in the hospital name, address, state, and zip code as well as the CMS certification number and the date of the survey site visit.
3. Continue to complete questions regarding the total number of surveyors and the time spent on-site for the combined PSI surveys. Also indicate the hospital's participation in Medicare via accredited status and the details if applicable.
4. Move to Part 2 and select three distinct quality indicators. For each selected indicator, assess and provide evidence related to improved health outcomes, appropriate data collection, and method specifications.
5. For each quality indicator, confirm whether the data collection matches the specified methods and whether the data has been satisfactorily analyzed.
6. Proceed to Part 3, detailing any improvement activities and performance improvement projects related to your selected indicators. Justify your project selections with evidence.
7. Review Part 4 focused on patient safety and adverse events. Document findings about staff training, safety expectations, and the hospital's methods for identifying and reporting adverse events.
8. In Part 5, confirm the existence of a formal QAPI program with proper governance and resource allocation. Supply documentation that supports compliance assessments.
9. After all sections are completed, ensure to save your changes. You can download, print, or share the completed form as required.

Start completing the CMS Hospital Quality Assessment Performance Improvement (QAPI) Worksheet_DSA online today to ensure compliance and enhance patient care.