School of Social Work, University of Missouri, Columbia (Dr Canada); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee (Dr Galambos and Ms Rollin); and Sinclair School of Nursing, University of Missouri, Columbia (Ms Pritchett and Drs Popejoy, Vogelsmeier, and Rantz).

Correspondence: Kelli E. Canada, PhD, MSW, School of Social Work, University of Missouri, Columbia, MO 65211 ([email protected]).

This project is supported by grant number 1E1CMS331080 from the Centers for Medicare & Medicaid (CMS) Innovations Center and Medicare-Medicaid Coordination Office (http://innovation.cms.gov/initiatives/rahnfr/), which is focused on improving care and outcomes for Medicare-Medicaid enrollees residing in nursing facilities.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the CMS. The authors acknowledge the gracious participation of 16 nursing homes in the St Louis area, their staff, the APRNs, and other staff of the MOQI Initiative.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com).

Accepted for publication: January 30, 2020

Published ahead of print: March 5, 2020