DescriptionPurpose of Project: Improve cascade communication for quality measures in frontline nursing home (NH) staff using evidence-based communication plan measured through baseline/follow-up retrospective chart audit and staff feedback. Methodology: Using Kotter’s change model, this QI project occurred at a 110-bed NH. A CMS quality measure (QM), ‘percent of residents whose need for help with activities of daily living has increased’ is derived from staff charting of NH residents’ activities of daily living (ADLs). Frequently missing, incomplete, and inaccurate ADL notes increase the risk of inaccurate QM data. Project activities (quality measure awareness at daily huddles, role play, and in-person discussions) occurred between September and November 2021. Outcomes were measured through retrospective chart audits across all shifts (N-night, D-day, E-evening), and staff feedback (baseline/follow-up) obtained using the Team Development Measure (TDM) tool. Results: Baseline chart audits (n=84) indicated 36 missing/60 incomplete /64 inaccurate ADL notes. Follow-up audits (n=84) showed 45 missing/59 incomplete/59 inaccurate ADL notes. Gaps persisted except incomplete and inaccurate evening shift notes which improved by 15.78% and 17.39%, respectively. No statistically significant relationships were identified between all ADL note categories - missing N/D/E notes (p= 1.000/p=0.400/p=0.371); incomplete N/D/E notes (p=0.646/p=0.581/p=0.223); and inaccurate N/D/E notes (p=0.703/p=0.285/p=1.000). Per TDM report, staff feedback from baseline (n=18) to follow-up (n=9) reflected a decline from stage 3 - building clarity of roles to stage 2 – building communication. Implications for Practice: Staff awareness of NH quality measures can promote safe resident-centered care, accurate data for quality measures, and reimbursement of NH care. Policies that address workplace barriers and staff accountability must be valued.