Partnership to Improve Dementia Care in Nursing Homes

In early 2012, the Centers for Medicare and Medicaid Services (CMS) established the National Partnership to Improve Dementia Care in Nursing Homes in response to an Office of the Inspector General (OIG) report underscoring the high use of atypical antipsychotic medication for "off-label" indications among nursing home residents.  This initiative is being supported by nursing home advocates, provider associations, and other stakeholders.

Since the initiation of the partnership, CMS has continued to monitor the progress of each state in their efforts to reduce the use of antipsychotic medications among nursing home residents.  The initial focus of the partnership was and remains on reducing the use of antipsychotic medications.  The partnerships larger mission is to enhance the use of non-pharmacologic approaches and person-centered dementia care practices.

The Health Standards Section (HSS) of the Louisiana Department of Health in conjunction with the Louisiana Dementia Partnership Coalition are very proud to announce the progress that Louisiana nursing facilities have made in the reduction of antipsychotic use for long-stay residents.  The graph below indicates Louisiana’s downward trend from Quarter 4 of 2012 when the CMS Initiative to Improve Dementia Care in Nursing Homes first began until the Quarter 4 of 2015.

Although Louisiana is still above the national average, the progress toward reduction is very evident.      

The National Partnership set forth the mission of the initiative to deliver health care that is person-centered, comprehensive, and interdisciplinary.   A specific focus has been set on protecting residents from being prescribed antipsychotic medications unless there is valid clinical indications for such in association with a systematic process to evaluate each individual’s needs. 

The LA Coalition has worked diligently to provide educational opportunities and resources for providers and practitioners to assist them in developing facility practices that would ensure safe and successful antipsychotic medication reduction.  They have also worked to assist facilities in the removal of identified barriers to success.

Nursing facilities are to be commended on the efforts put forth thus far in response to this initiative.  The data in the graph above and the workshop attendance records reflect the commitment made by many facilities to meet the national partnership’s mission and goals.

All are encouraged to continue the work that has been started.  At least on a quarterly basis, CMS and HSS will continue to track the progress being made by each individual nursing facility utilizing those national reports received.   The expectation is that nursing facilities will put systems in place to address the use of antipsychotic medications within their homes.  Failure to indicate such systems and progress toward the necessary reductions and sustained approach may result in an onsite investigation regarding such use and facility practices.

Click on the CMS National Partnership to Improve Dementia Care in Nursing Homes webpage to learn more

LDH Health Standarsds Section Memos to Provider

1. Dementia Training Requirements and CMS Hand in Hand Toolkit
2. Letter to Provider from LDH HSS