Overview of
AAHSA Quality First
Quality First is a philosophy of quality and a framework for earning public trust in aging
services. Quality First is a renewal of our commitment as aging services providers to help older
adults and their loved ones live their lives to their fullest potential.
Through Quality First, we will work in partnership with all stakeholders – government,
consumers, and the people we serve and their families – to create quality of care and quality of
life in aging services. Consumers must feel confident that they are receiving the high quality care
and services they deserve.
American Association of Homes and Services for the Aging (AAHSA), the American Health
Care Association (AHCA) and the Alliance for Quality Nursing Home Care launched Quality
First in July 2002.
Quality First applies to all aging services providers: nursing homes, continuing care retirement
communities, assisted living and senior housing facilities, and community service organizations.
The core of AAHSA Quality First is the 10 Elements of Quality:
1) Commitment
2) Governance and Accountability
3) Leading-Edge Care and Services
4) Community Involvement
5) Continuous Quality Improvement
6) Human Resources Development
7) Consumer-Friendly Information
8) Consumer Participation
9) Research Findings and Education
10) Public Trust and Consumer Confidence
The seven principles of Quality First are intended to cultivate and nourish an environment of
continuous quality improvement, openness and leadership among aging services providers:
1) Continuous Quality Assurance and Quality Improvement
2) Public Disclosure and Accountability
3) Patient/Resident and Family Rights
4) Workforce Excellence
5) Public Input and Community Involvement
6) Ethical Practices
7) Financial Stewardship
These are the outcomes expected from Quality First:
1) There will be demonstrated continued improvement in compliance with applicable
federal and state regulations.
2) There will be demonstrable progress in promoting financial integrity and preventing
occurrences of fraud.
3) There will be demonstrable progress (and continued compliance) in the prevention of
abuse and neglect.
4) There will be progressive and/or sustained achievements in quality of clinical
outcomes.
5) Consumers will report high satisfaction with care and services.
6) There will be demonstrable improvement in employee retention and turnover rates.
Quality improvement is both a philosophy and a management method based on the belief that
improvement is always possible. It ensures that policies and practices at every level of an
organization are geared to the provision of quality care and services.
Aging services organizations achieve quality improvement by establishing processes that enable
them to continually assess what they do and how they do it. The processes may address methods
to monitor a resident’s or client’s needs, to job design and training for staff, or to change the
culture of an organization. Staff at every level must be active in quality improvement. The board
of directors or trustees have an important role to play, also.
Individually for AAHSA members, Quality First is self-monitoring. By signing the Quality First
Covenant and making a commitment to quality, AAHSA members should set their own
benchmarks – and “raise the quality bar.” As a result, they should expect to see continuing
improvements in their organizations.
On a national basis, the National Commission for Quality Long-term Care will be “monitoring”
the field. The Commission will evaluate quality of aging services, identify factors influencing the
ability to improve quality of care nationally, and make recommendations about national efforts
that would lead to sustainable quality improvement.
At AAHSA, the Director of Quality First is Bruce Rosenthal; he can be contacted at
brosenthal@aahsa.org or 202-508-9499.
For more information about AAHSA Quality First, see www.aahsa.org/qualityfirst.
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