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Skilled Nursing Care Centers Reach Milestone in Reducing Antipsychotic Use in Residents with Dementia  
Skilled Nursing Care Centers Reach Milestone in Reducing Antipsychotic Use in Residents with Dementia
AHCA and CMS joint announcement sets goals to further decrease use
(202) 898-3165


Washington, DC – Alongside Administration officials from the Centers for Medicare and Medicaid Services (CMS), the American Health Care Association (AHCA) today announced the attainment of a nationwide goal to safely reduce the off-label use of antipsychotic medications in America’s skilled nursing care centers. As part of CMS’ Partnership to Improve Dementia Care in Nursing Homes (Partnership) and AHCA’s Quality Initiative, skilled nursing care centers reached a goal to reduce the use of antipsychotics by 15 percent, achieving a 15.1 percent reduction between the end of 2011 and 2013. The achievement improves the lives of approximately 40,100 nursing center residents living with dementia who are no longer receiving these medications as a result of the profession’s efforts.

“Reaching this goal means skilled nursing care centers now have concrete data to demonstrate our profession’s commitment to improving the quality of life for individuals living with dementia,” said AHCA President and CEO Mark Parkinson. “With help from CMS, we’ve been able to learn, grow, educate and improve for the benefit of all. The partnership between the skilled nursing profession and CMS is now a winning example of how government and health care providers can work together to address important issues and produce measurable results.”

CMS and AHCA are tracking the progress of the Partnership and the Quality Initiative by reviewing a publicly-reported measure - the percent of long-stay nursing center residents who are receiving an antipsychotic medication, excluding those residents diagnosed with schizophrenia, Huntington's Disease or Tourette’s Syndrome. The baseline for improvement is fourth quarter 2011, which saw 23.8 percent of long-stay residents receiving an antipsychotic. The two-year 15.1 percent decrease by nursing centers means 20.2 percent of long-stay residents were receiving an antipsychotic in fourth quarter 2013.

Additionally, AHCA heralded its more than 9,600 member skilled nursing care centers which achieved a faster rate of reduction and a lower rate of usage than the rest of the nation. AHCA member centers safely reduced antipsychotic medication use by 17.3 percent between fourth quarter 2011 and fourth quarter 2013. The larger reduction means 19.6 percent of residents in AHCA member centers were using an antipsychotic in fourth quarter 2013.

AHCA and CMS today also announced new goals to further decrease the use of antipsychotics in skilled nursing centers:
• an additional 10 percent nationwide reduction by the end of 2015;
• and another 5 percent nationwide reduction by the end of 2016.
This would result in a total reduction of antipsychotic use by 30 percent over a five-year effort of both the Partnership and the Quality Initiative.

“We want to build upon this incredible success,” said Dr. David Gifford, AHCA Senior Vice President of Quality and Regulatory Affairs and a board-certified geriatrician. “Going from nearly one in four residents on an antipsychotic to one in five is impressive, but we know this is still too high. After seeing the great work long term care professionals have done to address this issue, we are confident we can continue to reduce this number.”

The use of antipsychotic medication as an attempt to modify behaviors associated with dementia is not supported clinically and is considered off-label by the Food and Drug Administration. These medications may be appropriate for individuals suffering from schizophrenia or bipolar disorder, but in the elderly living with dementia, they increase the risk of complications resulting in poor health and high costs. As information about this issue has emerged over recent years, AHCA has been vocal to its member centers, other stakeholders and consumers about safely decreasing the use of antipsychotics and promoting more person-centered care.

About the AHCA Quality Initiative
The Quality Initiative is an effort that builds upon existing work of the long term and post-acute care profession in advancing quality care by setting specific, measurable targets to further improve quality of care in America’s skilled nursing centers and assisted living communities. Among the Quality Initiative’s four priorities is a goal to safely reduce the off-label use of antipsychotic medications. The Quality Initiative embraces CMS’s Triple Aim of Better Health, Better Quality and Reduced Costs. For more information, please visit


The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents more than 14,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and development disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the nearly 5 million seniors and individuals with disabilities who receive long term or post-acute care in our facilities each year. For more information, please visit or​​