The goal of quality initiatives is to promote safe, timely, effective, efficient, and equitable patient-centered care (DeNisco and Barker, 2013). Quality improvement assessment is important in the healthcare industry to discover best care practices and provide high-quality, cost-effective care to patients. Public and private agencies are the regulatory entities in the healthcare industry that promote the quality and safety of healthcare delivery. The primary regulatory agencies are CMS, the Joint Commission, and AHRQ (deNisco & Barker, 2013). Public agencies such as CMS have periodically made drastic changes to their reimbursement policies. In 2003, CMS launched the Hospital Quality Initiative and Home Care Quality Initiatives (Denisco and Barker, 2013). The hospital quality initiative primarily focused on acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PNE). Home care quality initiatives have also focused on quality measures for individuals receiving home care services (DeNisco & Barker, 2013). In 2001, approximately 3.5 million elderly and disabled Americans received care from 7,000 Medicare-certified home health agencies and approximately 3 million elderly and disabled Americans received care from 17,000 Medicare-certified nursing homes. and Medicaid (DeNisco & Barker, 2013). In 2004, the CMS Nursing Home Quality Initiative launched 14 quality measures in the areas of delirium, pain (acute and chronic), incontinence, decline in activities of daily living, physical constraints, Worsening anxiety and depression, pressure sores, indwelling catheters, mobility. decline, bedrest, weight loss, and urinary tract infections (DeNisco & Barker, 2013). The National...... middle of article ...... References Blum,J.,(2011). Improving Quality, Reducing Costs: The Role of the Health Care Delivery System: U.S. Department of Health and Human Services. Retrieved from http://www.hhs.gov/asl/testify/2011/11/t20111110a.htmlDeNisco, SM, & Barker, AM, (2013). Advanced practice nursing: evolving roles for profession transformation (2nd ed.). Boston: Jones & Barlet. Ruppert, S, D., Shiao, S, K., Tolentino-DelosReyes, A.F., (2007). Evidence-based practice. Using the Ventilator Bundle to Prevent Ventilator-Associated Pneumonia (3rd ed.). American Journal of Critical Care. Pesah, S.K., McKay, N., Harman, J.S., Amin, M., Cook, R.L (2013). Medicare nonpayment for nosocomial infections: infection rates three times after implementation. Centers for Medicare and Medicaid Services.