LTC will face more pressure to lessen antipsychotics, government officials say

The push for long-term care facilities to abandon the use of off-label use of antipsychotic medications for residents with dementia will intensify over the next two years, Centers for Medicare & Medicaid Services officials said Thursday.

The National Partnership to Improve Dementia Care is pushing forward with a 25% reduction of the medications by the end of 2015, which it wants to hit 30% by the end of next year, according to CMS coordinator Michelle Laughman, speaking during a CMS Open Door Forum call. Nursing homes reached the national goal of a 15.1% reduction in 2013.

“We're working towards that 25% goal,” Laughman said. “But there's still many homes across the country that continue to have higher rates than the national average, and we're looking at that.”

The cornerstones for antipsychotic medication reduction include person-centered care, training of facility management and staff, and embracing culture change, Laughman said.

Laughman also announced the expansion of the Partnership's Focused Dementia Care Survey Pilot, which ran in California, Illinois, Louisiana, Minnesota and New York. Texas and Mississippi are among the first states to join the expanded pilot.

“We learned a lot of great things from the pilot and we realized it was an excellent training experience,” Laughman said. “Again we found that calling on family members, physicians and nurse practitioners is certainly an essential component, and the observations through the process are a critical piece.”

The CMS Open Door Forum also included an update on CMS's Electronic Staff Data Collection, which will begin registration for voluntary payroll-based journal submissions in early August.