P008: Percent of long-stay nursing home residents who are receiving psychoactive drugs but do not have evidence of psychotic or related conditions
Story Behind the Curve
- Nationally, over half of nursing home residents have some form of dementia and many experience related behavioral and psychological symptoms. The US Centers for Medicare and Medicaid Services (CMS) partners with states, nursing homes, and others to improve dementia care with a focus on person-centered and comprehensive healthcare to significantly reduce the use of antipsychotics for nursing home residents without a valid clinical reason or evaluation. The initial goal was to reduce the use of antipsychotic medication by 15%, then by 30% in 2016. As of 2016, the national average is 16.1%.
- Antipsychotic medications may contribute to falls, withdrawal, and other behaviors that harm a resident’s health or quality of life. Therefore, it is important that we work toward reducing the use of these psychoactive drugs among patients that don't have evidence of psychotic or related conditions.
- In FY16, the annual use of psychoactive drugs by residents at long-stay nursing homes was 17.1 %. The use of antipsychotic medications was reported at 17.95% for the second quarter of FY17, there is a two quarter lag in data availability.
- Information is tracked through the Minimum Data Set (MDS). Nursing homes are required to maintain current and accurate MDS records for all residents.
- By sharing best practices, and trends in data with trade organizations, the Division of Health Improvement (DHI) can work with nursing homes to reduce the use of antipsychotic medications.
- Nursing home facilities
- New Mexico Health Care Association (NMHCA)
- Providing guidance on appropriate antipsychotic prescriptions in nursing home facilities according to CMS' quality initiative.
- Using data to inform decisions about training and compliance.
- Partner with NMHCA and nursing homes, to:
- Share data and trends;
- Provide training and information regarding the CMS quality initiative.
- DHI will continue to track and trend the measure annually. Ongoing.
- Meet with partners, the NMHCA, HealthInsight, and nursing home to identify strategies to further reduce antipsychotic drug use. Completed.
- Research initiatives other states have used. Completed.
- Develop an action plan to implement effective strategies. Completed.
- Meet with the Nursing Home Association clinical team to review CMS antipsychotic data and to explore ways the Association leadership could use Civil Monetary Penalty funding to improve outcome data. Completed.
- Monitor nursing home facilities for the appropriate use of antipsychotic medication use. Completed.
- Continue to track, monitor and report data to the Nursing Home Association Quarterly. Completed.
- Continue to track and monitor the effectiveness of the action plan and report results to NMHCA and partners. Completed.
FY17 Annual Progress Summary
- This is a new explanatory measure for DHI.
- In FY16 (note, there is data lag in reporting), the use of antipsychotic medication without evidence of a psychotic or other related condition was 17.1%.
- To improve (decrease the use of antipsychotic medications among residents that don't need it), DHI collaborates with the New Mexico Health Care Association and nursing homes to share data, trends, and provide training and information regarding the CMS quality initiative.