Resident-on-resident mistreatment is an urgent problem, researchers say

Long-term care providers are being asked to reduce the use of antipsychotic medications among residents by 25% by the end of 2015, and 30% by the end of 2016.

The National Partnership to Improve Dementia Care, a public-private coalition that includes the Centers for Medicare & Medicaid Services, the American Health Care Association/National Center for Assisted Living and LeadingAge, announced the goal Friday in a conference call with members of the media.  

The percentage decrease goal is based on rates from 2011. Over 21 months through the end of 2013, the national rate was reduced by 17.1 % — from 23.8% to 19.8% — CMS said. States with the highest decreases were Hawaii (31.4%), North Carolina (29.9%), Vermont (28.2%) and Georgia (28.1%).

“The results speak for themselves,” AHCA President and CEO Mark Parkinson said Friday. “Behind each of those percentages are thousands of lives that are being improved.”

Treatment of dementia patients does not only impact nursing homes, but also home-based caregivers, said LeadingAge President and CEO Larry Minnix.

“As we continue to make progress in nursing home settings, where people often have to turn for dementia care, we look at it as not merely a nursing home issue,” he said. “We’re on the front end of a revolutionary change with how people with this tough condition can be treated.”

In addition to CMS’ Nursing Home Compare website including the use of each nursing home’s antipsychotic rate, CMS’ Chief Medical Officer Patrick Conway, M.D, said that the Five Star Quality Rating System will start including that measure in 2015. The rating system has recently come under fire, and Conway said that CMS was looking at nursing homes and other “potential updates” for consideration.

Conway, also the agency’s deputy administrator for innovation and quality, mentioned that a review of surveyor feedback, additional opportunities to report on national dementia care and technical assistance for Quality Improvement Organizations are among the “critical work ahead” for the agency in efforts to reduce the use of antipsychotics.

“Ultimately, nursing homes should re-think their approach to dementia care, re-connect with the person and their families, and use a comprehensive team-based approach to provide care,” he said in a statement.

Also participating in the media conference call were Christopher Laxton, executive director at AMDA — The Society for Post-Acute and Long-Term Care Medicine; Doug Pace, the executive director at Advancing Excellence; and Adrienne Mims, M.D., the president at the American Health Quality Association, which represents QIOs. She described the group as being part of “boots on the ground” and commented that, based on other states’ success with antipsychotic reduction, “these are very realistic goals.”

CMS released an additional fact sheet on antipsychotics data that can be seen here