Nursing Facility Quality Review

HHSC has contracted with The University of Texas at Austin School of Nursing Center for Excellence in Aging Services and Long-Term Care for the NFQR 2019 data collection. Nurse quality reviewers from the Center will visit 400 Medicaid-certified nursing facilities across the state, using a structured survey tool to collect data. In 2019, the NFQR will also expand to include residents in a random sample of residents in 35 assisted living facilities. The onsite reviews will run through December 2019.

Nurse quality reviewers — who are not HHSC regulatory staff or quality monitors — will conduct assessments and resident interviews using a structured survey tool.

Using funds allocated by the General Appropriations Act (Senate Bill 1, 85th Texas Legislature, Regular Session, 2017), the review’s focus is determining quality of care and resident satisfaction with quality of life.

The information collected will help HHSC track progress in current quality improvement activities as well as develop strategies for new initiatives to improve the quality of care and quality of life for residents of Texas nursing homes.

Facility Responsibilities

The nurse quality reviewers have Texas Health and Human Services Commission authorization to perform interviews and assessments as well as review and obtain copies of specific clinical documents. This process meets all requirements of HIPAA privacy rules.

Nursing homes must provide nurse quality reviewers access to residents and their clinical records (40 TAC §19.2302(h), Uniform Managed Care Manual Chapter 8.6 State Mandated Requirements for Nursing Facility Providers 2.3.1(6)).

Failure to cooperate with these requirements may result in the HHSC Office of the Inspector General imposing sanctions against the facility (1 TAC §371, Subchapter G).

Assisted living facilities are also required to provide the nurse quality reviewers with access to their residents and clinical records (40 TAC, Chapter 92, §92.41(o) and §92.81(f)).

NFQR Methodology

The NFQR includes a valid random sample of residents across the state living in Medicaid-certified nursing facilities. These residents are assessed and interviewed by an independent contractor, using a structured survey tool. In addition, a random sample of residents in 35 assisted living facilities will be assessed and interviewed.

HHSC uses statistical software to analyze the data and test for linear trends across time to help the agency track progress in quality improvement activities and formulate strategies to improve both the quality of long-term services and supports and clinical outcomes of nursing home residents.

Read the Reports

A written report on the findings of the survey will be prepared and posted on the HHSC website. Only aggregate data is included in the report. Email us to request a copy of a report.

To Learn More

For more information about the NFQR, please visit The University of Texas at Austin School of Nursing’s NFQR website or contact the Quality Monitoring Program at