On a recent AMDA - The Society for Post-Acute and Long-Term Care Medicine (formerly known as the American Medical Directors Association) State Presidents’ conference call, we recently had a chance to review this report and were given permission to release this report to our readers.

As those working in LTC, many of us are familiar with reasons for this partnership and the pressure to reduce the inappropriate use of antipsychotics in our patients with dementia problem behaviors.  While this is a rather extensive document, I commend the executive summary for this painstaking review.

We should be grateful that CMS has taken a partnership approach to this complex problem rather than a pure regulatory intervention.  I was pleased to see that the target of reducing antipsychotic use by 15% was achieved by 18 months into the project.  Practical tools like the free ‘Hand in Hand” training tools for CNAs are noted as well as numerous other potential constructive approaches to creating person centered care plans and healthier environments for living.  Outcomes measures for long-stay and short-stay residents still vary widely, but are now available on a national and local basis so that it’s clear if you are an outlier.  This level of accountability, while sometime painful, should ultimately lead to a better life for our residents and their families.

At CALTCM, you’re not alone.  We look forward to continuing our work with you, and with the California Partnership to Improve Dementia Care, along with our colleagues at CDPH, CAHF, CANHR, Culture Change and CMS, among others, to provide state-specific assistance.  As a final note, let me share the latest California data-- our antipsychotic rate in long-stay nursing home residents in 2012 was over 20%, and now is down to 16.6% as of the fourth quarter of 2013.  The nationwide average is still over 20%.  So we are really showing some excellent progress, and hope to keep that going!

Click here to access report