by Anthony Chicotel, CANHR Staff Attorney
With a decent amount of fanfare, the Center for Medicare and Medicaid Services (CMS) and the nursing home trade group American Health Care Association (AHCA) recently announced an initiative to reduce the unnecessary use of antipsychotic drugs in nursing homes. At the heart of the initiative is a pledge to reduce the use of antipsychotics by 15% by the end of 2012.
A 15% reduction in use would certainly be a welcome development but even this modest goal is undermined by a bit of accounting sleight of hand. It turns out that residents who have been in the facility for less than 100 days will not be counted in the mix. Thus, the rather substantial population of residents who stay in a nursing home for a few months or less (upwards of 70% of all residents) will only peripherally benefit from the national initiative.
In a nursing home system where more than half of all antipsychotic prescriptions do not meet the criteria for Medicare cost reimbursement and cheaper, safer non-pharmacologic options for dementia care are often not seriously considered, a 15% reduction in antipsychotic use among only 30% of the total residents is a woefully inadequate goal. What about the untold number of residents who will remain unnecessarily drugged?
To that we say: “We are the 85%!”
CANHR has been generally pleased by the nationwide focus on reducing the misuse of antipsychotics in nursing homes. We believe that wrongful drugging is finally receiving its proper emphasis as the nursing home issue of our time. However, the importance of the message is substantially weakened when the resulting plan addresses only a tiny fraction of the overall number of victims.
We think that we can, and absolutely have to, do better.