New Government Report Shows Continuing Decline in Antipsychotic Use Among Long-Stay Nursing Home Residents

AHCA Quality Initiative Spearheads National Improvements

Washington, DC — A new report issued by the National Partnership to Improve Dementia Care in Nursing Homes — a public-private coalition under the direction of the Centers for Medicare & Medicaid Services (CMS) — shows a greater-than-expected decrease in the national prevalence of antipsychotic medication use in long-stay nursing home residents over the last three years.
According to quality data compiled by CMS, 19.2 percent of long-stay nursing home residents were receiving an antipsychotic medication in the third quarter of 2014 compared with 23.9 percent in the fourth quarter of 2011 — representing a decrease of 19.4 percent.
“These new data are further evidence of the success of the Quality Initiative our Association embarked on three years ago,” said Mark Parkinson, President and CEO of the American Health Care Association (AHCA).
In February 2012, AHCA launched its Quality Initiative with four specific goals for the profession over three years. One of its goals was a 15 percent reduction in the off-label use of antipsychotic medications. Later that year, AHCA joined CMS in supporting its National Partnership to Improve Dementia Care in Nursing Homes, which had a similar 15 percent reduction goal for these medications.
“Even with this announcement, we won’t stop. We can do better,” said Parkinson. “And with the help and collaboration of CMS, families, and all of our partners, we can further lower the use of these medications in our centers. Now that we have exceeded our initial objective, we have set even more ambitious goals to further decrease the use of antipsychotics in skilled nursing centers an additional 10 percent nationwide by the end of 2015, and another 5 percent by the end of 2016.”
Parkinson noted that the trend of improvement in antipsychotic use is consistent with across-the-board improvements in other quality metrics.
“The use of antipsychotic medication as an attempt to modify behaviors associated with dementia is not supported by the research studies,” said Dr. David Gifford, AHCA Senior Vice President of Quality and Regulatory Affairs and a board-certified geriatrician. “These medications may be appropriate for individuals suffering from schizophrenia or bipolar disorder, but in the elderly living with dementia, they can increase the risk of complications, resulting in poor health outcomes and higher costs.
“As information about this issue has emerged over recent years, AHCA has been a vocal advocate to its member centers, other stakeholders and consumers about safely decreasing the use of antipsychotics and promoting more person-centered care,” said Gifford.
“The success of our profession in achieving a nearly 20 percent reduction in the use of antipsychotics over the last three years means that we have helped to improve the quality of life for thousands of individuals with dementia residing in our nation’s skilled nursing centers,” Gifford added.
Highlights of the report released on January 23, 2015, by the National Partnership to Improve Dementia Care in Nursing Homes are below. Data exclude residents diagnosed with schizophrenia, Huntington’s Disease or Tourette’s Syndrome.

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Quarterly Prevalence of Antipsychotic Use for Long-Stay Residents, CMS Regions*
2011Q2 to 2014Q3
*  Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont; Region 2: New Jersey, New York, Puerto Rico, Virgin Islands; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin; Region 6: Kansas, Louisiana, New Mexico, Oklahoma, Texas; Region 7: Iowa, Kansas, Missouri, Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming; Region 9: Arizona, California, Hawaii, Nevada, Pacific Territories; Region 10: Alaska, Idaho, Oregon Washington