Long-term care providers achieved 15% antipsychotic reduction goal, CMS announces

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Nursing home staffing standards reduced severe deficiency citations, researchers find
Nursing home staffing standards reduced severe deficiency citations, researchers find

Long-term care facilities have reduced antipsychotic medication use by more than 15% through a large-scale initiative, according to a new report from the Centers for Medicare & Medicaid Services. That means it's time to set a more ambitious goal, a subgroup says.

The National Partnership to Improve Dementia Care in Nursing Homes was formally launched in 2012, with the primary goal of reducing the prevalence of antipsychotic prescribing for dementia care by 15% within a year. The initiative joined public and private organizations that educated providers and offered resources to help them transition residents off of antipsychotics. While it took longer than a year to achieve the sought after reduction, the goal was met in the fourth quarter of 2013, according to an interim CMS report released Friday.

Specifically, the national prevalence of antipsychotic use among long-stay nursing home residents has decreased 15.1% from the fourth quarter of 2011, the report states. The overall antipsychotic prescribing rate for this population was 20.2% in the fourth quarter of 2013.

The statistic that one in five long-stay residents still is on an antipsychotic shows that “there's still a long way to go,” said Cheryl Phillips, M.D., senior vice president for policy at long-term care provider association LeadingAge.

However, the CMS numbers affirm a “progressive decline” in antipsychotic use, Phillips told McKnight's.  The fact that every state achieved a decline is notable and suggests that “flywheel momentum” might now lead to continued progress, particularly as the long-term care culture change movement spreads, she said. The implementation of team-based, person-centered care should continue to drive antipsychotic use down, but it is not a speedy process, Phillips noted.

“This is just the beginning of these more long-lasting transformational changes that go beyond just antipsychotics,” she said.

American Health Care Association/National Center for Assisted Living President and CEO Mark Parkinson also emphasized that while this is a "moment to celebrate," improving care quality remains the "constant focus" of the organization. AHCA — the largest long-term care provider association in the nation — was "proud to partner with CMS" on the initiative, he added.

"Skilled nursing centers around the country should be applauded for this milestone achievement and take solace in the lives they have forever changed," Parkinson said in an emailed statement to McKnight's. 

Now that its initial goal has been realized, CMS will set a new one for 2014, according to the report. Some states already have set ambitious objectives, including California's target of a 30% reduction in antipsychotic prevalence, the report notes.

Click here to access the complete document. 

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