SNF‘s are complex organizations that cater to the needs of frail patients, including those with HF. High-quality HF care delivery in SNFs requires the implementation of Qi initiatives that follow a proven framework. In the current study. the authors used the framework of complexity science and reflective adaptive processes to implement a model of high-quality HF care in one SNF. This Specific: approach entails the engagement of relevant stakeholders and frontline staff members and provides a footprint for future HF-related Qi initiatives in SNFs