Partnership to Improve Dementia Care in Nursing Homes

As seen in the Consultant Connection September 2015 Issue
Todd Harris RPh, CGP, Director of Consulting Pharmacy and the National Partnership to Improve Dementia Care August 2015 News Release
Antipsychotic Drug use in Nursing Homes Trend Update
In 2012, CMS launched the National Partnership to Improve Dementia Care in Nursing Homes with the mission to improve quality of care for nursing home residents living with dementia. This Partnership, that includes federal and state agencies, nursing homes, pharmacy providers, advocacy groups and caregivers, continues to focus on the delivery of health care that is person-centered, comprehensive and interdisciplinary, in addition to protecting residents from being prescribed antipsychotic medications unless there is a valid, clinical indication and a systematic process to evaluate each individual.
CMS is tracking the progress of the Partnership by reviewing publicly reported measures. The official measure of the Partnership is the percentage of long-stay nursing home residents who are receiving an antipsychotic medication, excluding those residents diagnosed with schizophrenia, Huntington’s Disease or Tourette’s Syndrome. In 2011Q4 23.9% of long-stay nursing home residents were receiving an antipsychotic medication; since then there has been a decrease of 21.7% to a national prevalence of 18.7% in 2015Q1. Success has varied by state and CMS region, with some states and regions having seen a reduction of greater than 20%. A three-quarter measure is posted to the Nursing Home Compare website at www.medicare.gov/nursinghomecompare. The long-stay measure on Nursing Home Compare, is the exact same measure as below, except each facility’s score is averaged over the last three quarters in order to give consumers information on the past history of each facility. For more information on the National Partnership to Improve Dementia Care, please see https://www.nhqualitycampaign.org/dementiaCare.aspx.
Antipsychotic use has long been a primary focus of ICP consultants to ensure that medications are being used appropriately and at the lowest effective dose.   ICP pharmacists have been able to make a large impact on our facilities’ overall antipsychotic use through education, procedure changes within the facility, and intervention documentation.  Many of our facilities have been able to significantly reduce their prevalence of antipsychotic use - over 65% in some cases. This focus has become even more important recently since each facility’s antipsychotic use is now part of their quality measures and their 5-Star rating.   As CMS continues to evaluate antipsychotic use and revises regulations, our consultants will continue to work with our customers to help them meet their goals.
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