MDS Alert

The National Partnership to Improve Dementia Care has surpassed its goal in reducing the use of antipsychotics in nursing homes — but get ready for a new, steeper goal.

From the end of 2011 to the end of 2013, the national prevalence of antipsychotic use in long-stay nursing home residents decreased by 15.1 percent (from 23.8 percent to 20.2 percent), according to a Sept. 19 Centers for Medicare & Medicaid Services (CMS) press release. This slightly exceeded the Partnership’s goal of a 15-percent reduction.

Prepare yourself: The Partnership’s new goals are reductions of 25 percent by the end of 2015 and 30 percent by the end of 2016. And CMS will actively monitor your facility’s use of antipsychotics, as well as review prescriptions of anxiolytics and sedatives/hypnotics to make sure you’re not simply replacing antipsychotics with other drugs.

“In addition, CMS will review the cases of residents whose antipsychotics are withdrawn to make sure they don’t suffer an unnecessary decline in functional or cognitive status as a nursing home tries to reduce its usage,” the press release states. 

Impact: CMS currently posts measures of each nursing home’s antipsychotic medication use on the CMS Nursing Home Compare website, but in the next few months CMS will add the antipsychotic measure to the calculations it makes for each nursing home’s rating on its Five Star Quality Rating System.

Learn More About Your LGBT Residents

If your staff needs training in understanding the rights and needs of older lesbian, gay, bisexual, and transgender (LGBT) adults, there’s a new free online learning tool available for just that.

The Administration for Community Living and the Administration on Aging developed the online learning tool, “Building Respect for LGBT Older Adults.” The Centers for Medicare & Medicaid Services (CMS), HHS Office of Public Affairs, and the National Resource Center on LGBT Aging also collaborated on developing the tool.

The tool is for long-term care and other aging service providers, meant as an introduction to LGBT aging. The tool is arranged in six modules, each approximately 10 minutes long. Although you don’t need to watch all the modules at once, you should follow the consecutive order.

“This tool is a first step in learning about how to create safe, welcoming and inclusive services for LGBT older adults,” states the National Resource Center on LGBT Aging. You can access the online learning tool at http://lgbtagingcenter.org/training/buildingRespect.cfm.

How Your Five Star Measurements Will Soon Change

On Oct. 6, the Centers for Medicare & Medicaid Services (CMS) announced that it’s expanding and strengthening the Nursing Home Five Star Quality Rating System to improve consumer information. 

CMS will implement the improvements beginning in 2015. The changes will include:

• Upgraded user interface to ease navigation and improve the clarity of key metrics for both online and printable formats;
• Revised scoring methodology by which CMS calculates each facility’s quality measure rating;
• Increased number and type of quality measures that are not solely based on self-reported data;
• Improved linkage to state-based websites for improved access to information that is uniquely reported by individual states; and
• Improved reporting on nursing home staffing that increases the accuracy of data for staffing levels, as well as turnover and retention.

“Nursing homes are working to improve their quality, and we are improving how we measure that quality,” Patrick Conway, MD, CMS chief medical officer and deputy administrator for innovation and quality, said in the Oct. 6 announcement. “We believe the improvements we are making to the Five Star system will add confidence that the reported improvements are genuine, are sustained, and are benefiting residents.”

Resource: To access the Oct. 6 CMS fact sheet on these changes, go to www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-10-06.html.