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Table 4 Perceived Conflicts Between Regulations and Quality Improvement

From: Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

That in order to justify giving pain medication to a resident, the resident must be coded as having pain on the Minimum Data Set (MDS)
That problems should be corrected in a short amount of time, rather than through small changes that lead to improvement
That QIOs are doing research that requires permission from residents to participate
That identifying and documenting a problem that a facility team wants to improve will indicate to surveyors where the facility should be cited for non-compliance with the regulations