Highland Hills Post Acute: QAPI Training Failures - PA
The training they never received was on Quality Assurance and Performance Improvement, a program known in nursing home circles as QAPI. It is the internal system facilities are supposed to use to identify when care is falling short and fix it before residents are harmed. The employees responsible for carrying out that work, or at minimum for understanding how it functions, were never taught what it was.
Inspectors reviewed training records for five employees. Three of them had no documentation of QAPI education. The three were Nurse Aide Employee E15, Nurse Aide Employee E5, and Licensed Practical Nurse Employee E16.
The facility's own assessment, completed in the first quarter of 2025, said plainly what was supposed to happen. Staff training and education, the document stated, would be completed during general orientation upon hire, annually, and as needed. The list of required topics was specific: communication, resident rights and facility responsibilities, abuse, neglect and exploitation of residents, quality assurance and performance improvement, infection control, compliance and ethics, and behavioral health.
QAPI was not a footnote. It was written into the facility's own plan, alongside abuse prevention and resident rights, as a baseline expectation for every employee from their first days on the job.
The records showed it did not happen for three of the five staff members reviewed.
When inspectors reached the facility's Human Resources employee, identified in the report as Employee E9, by phone on the morning of September 25, 2025, the confirmation was immediate. The HR employee acknowledged that the facility had failed to provide QAPI training for the three staff members. There was no dispute about what the records showed.
The violation was cited at a level of minimal harm or potential for actual harm, meaning inspectors did not document a specific resident who was injured as a direct result of the training gap. But the structure of what was missing matters. QAPI is not a peripheral administrative exercise. It is the mechanism through which a nursing home is supposed to recognize its own failures, track patterns in resident outcomes, and implement corrections before those patterns become crises. When the staff working inside a facility have never been trained on that system, the system's ability to function depends on people who do not fully understand what they are supposed to be doing or why.
A licensed practical nurse is not a peripheral figure in a nursing home. LPNs administer medications, monitor residents for changes in condition, communicate with physicians, and document care. An LPN who has not been trained on the facility's quality assurance structure may not know how to flag a concern through that system, may not recognize when a pattern of incidents rises to the level that requires formal review, and may not understand their own role in the feedback loop the facility is supposed to maintain.
The two nurse aides face a similar gap. Nurse aides are typically the staff members with the most direct and sustained contact with residents. They assist with bathing, dressing, eating, and mobility. They are often the first to notice when something has changed with a resident. If they have not been trained on QAPI, they may not know that their observations are supposed to feed into a formal improvement process, or how to make that happen.
Highland Hills Post Acute's own facility assessment made clear that the facility understood this. The document did not frame QAPI training as optional or situational. It listed the training as part of general orientation, meaning it was supposed to happen before an employee was fully integrated into the facility's workforce, not sometime later, not as needed, but at the start.
The gap between what that document said and what the training records showed was what the inspection confirmed.
The complaint inspection was conducted on September 25, 2025. The HR employee's telephonic confirmation came at 9:52 in the morning. The facility did not contest the finding.
Pennsylvania citations in the inspection report referenced the state's nursing home licensure code, covering the responsibility of the licensee, management obligations, and staff development requirements. The federal form used to document the violation is the standard CMS-2567, the same form used to record deficiencies at nursing homes across the country.
What the inspection report does not say is how long the three employees had been working at the facility without the training. It does not say whether they were new hires whose orientation had simply been incomplete, or whether they had been on staff long enough that the annual retraining requirement had also come and gone without QAPI appearing on their records. It does not say whether any of them had raised concerns through the quality assurance process, or tried to, or whether the gap in their training had any practical effect on how they did their jobs on any given shift.
Those answers are not in the inspection report. What is in the report is the facility's own written commitment, the training records that contradicted it, and the HR employee who confirmed the contradiction without qualification.
Facilities that commit to training in their own assessment documents and then fail to deliver that training on the topics they themselves identified as essential are not facing an external standard they never agreed to. They are falling short of the standard they wrote for themselves.
The three employees at Highland Hills Post Acute who were never trained on QAPI were working inside a facility that had told regulators, in its own words, that every employee would receive that training. The records said otherwise. The HR department said so too.
Whether the gap was a paperwork failure, a scheduling oversight, or something more systemic in how the facility manages its training obligations is not something the inspection report resolves. What it resolves is that three people, including a licensed nurse, were doing their jobs inside a system they had never been taught to use.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Highland Hills Post Acute from 2025-09-25 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: September 13, 2026 · Our methodology
HIGHLAND HILLS POST ACUTE in PITTSBURGH, PA was cited for violations during a health inspection on September 25, 2025.
The training they never received was on Quality Assurance and Performance Improvement, a program known in nursing home circles as QAPI.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.