Thursday, July 19, 2012

The Quality Initiative: Reducing Antipsychotic Use

Today, the Centers for Medicare and Medicaid Services made their new Five-Star rating and quality measure information available online at Nursing Home Compare. This includes a facility’s rates on antipsychotic use—a focus of the AHCA/NCAL Quality Initiative.

We are only 164 days away from needing to achieve our goal to safely reduce the off-label use of antipsychotic medications by 15% at the end of this year.

If you’re a facility considering initiating an antipsychotic drug or re-evaluating the decision to initiate drug therapy, these critical questions are important to ask:
  1. What was done to try to figure out why the resident was doing (behavioral response)?
  2. What might the resident be trying to communicate to us by doing (behavioral response)?
  3. What do we believe the reason was for the resident doing (behavioral response)?
    Unacceptable answers are "dementia" or "sun-downing"
  4. What alternative approaches were tried before requesting medications?
  5. Is there a physical reason for the behavior like untreated pain?
  6. Is there an environmental reason for the behavior like over or under stimulation?
  7. Could other medication side effects be the cause of the problem?
We encourage you to access your specific rating measures regularly online in order to keep track of how you’re meeting the Quality Initiative goals.

If you want to learn more about the changes to Five-Star and Nursing Home Compare, there is a free archived webinar available to AHCA/NCAL members. Additionally, the provider Five-Star Help line (800-839-9290) will be open for an extended period from June 18 through August 3. Provider questions may also be addressed to

What are your facilities doing to safely reduce the off-label use of antipsychotics? 

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