Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE +
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
June 15, 2016 01:00 AM

CMS reports success in reducing overuse of antipsychotic drugs; patient advocates skeptical

Virgil Dickson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    The CMS says it has surpassed its goal for reducing the use of antipsychotic medications in nursing homes. Patient advocates, however, are expressing skepticism over the claim.

    In 2014, the agency said it would strive to reduce use of the drugs by 25% by the end on 2015. The agency beat that goal by cutting use of the drugs 28.8% nationally by the end of last year, according to a report (PDF).

    The analysis aimed at focusing on inappropriate use of the drugs by excluding patients diagnosed with schizophrenia, Huntington's disease or Tourette's syndrome.

    Industry was pleased with the progress. “This is a large change impacting thousands of residents, who are no longer receiving these antipsychotic medications that often are unhelpful and potentially harmful,” said Dr. David Gifford, senior vice president of quality and regulatory affairs at the American Health Care Association, a nursing home trade group.

    For years reports were pouring in from nursing homes around the country of patients not suffering for mental illness receiving antipsychotic drugs to suppress residents from acting out or showing signs aggression. The drugs are approved mainly to treat serious mental illnesses like schizophrenia and bipolar disorder.

    When given to other patients not suffering from a serious mental illness, such as those with Alzheimer's disease and related dementias, there has been a noted increased risk of falls due to impaired mobility, heart failure, infections and death.

    The CMS says its reduction estimates are based on the minimum data set (MDS), which is a standardized, primary screening and assessment tool used to asses care in a Medicare/ Medicaid-certified long-term-care facilities.

    However, the CMS has noted instances past that MDS data can be inaccurate when compared to a patient's medical records. For instance, a report last year found there were instances where the MDS data didn't match a patient's medical record 25% of the time.

    Concerns over the CMS' data source has resulted in advocates expressing some skepticism on whether there been a major drop in inappropriate use of antipsychotics in nursing homes.

    “The reduction in inappropriate administration of antipsychotic drugs is good, but too many nursing home residents, more than a quarter of a million people, continue to take these drugs and the overwhelming majority of residents should not be taking them,” Toby Edelman, senior policy attorney at the Center for Medicare Advocacy. “We have a long way to go to solving this problem.”

    AARP also raised concerns about the data used but gave the CMS some credit that at least some progress is being made.

    “It's great that it's going in the right direction, but the pace of change has been slow, especially given the potential consequences of the drugs,” said Kelly Bagby, senior counsel for AARP Foundation Litigation. “For people with dementia, use of the drug is especially dangerous because they can possibly die.”

    In 2011, HHS' Office of the Inspector General found 83% of atypical antipsychotic drug claims were for elderly nursing home residents who had not been diagnosed with a condition for which antipsychotic medications were approved by the Food and Drug Administration.

    In response to concerns that the facilities were routinely administering the drugs inappropriately, the CMS established a public-private alliance in 2012 called the National Partnership to Improve Dementia Care in Nursing Homes.

    The partnership includes the American Health Care Association, the American Health Quality Association, LeadingAge, the American Medical Directors Association and Advancing Excellence.

    Under the initiative, outreach is performed providers and provider associations, clinicians, researchers, advocates, government agencies, residents and families in every state about the dangers of off label use of the drugs.

    Of 2.1 million elderly nursing home residents, about 14% (304,983) had at least one Medicare claim for an atypical antipsychotic drug between Jan. 1 and June 30, 2007, according to a 2011 analysis by HHS' inspector general's office. Claims for elderly nursing home residents accounted for 20% of the total 8.5 million claims for atypical antipsychotic drugs for all Medicare beneficiaries, a cost of $309 million, the OIG found.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Hospital systems finance 3
    Mississippi lawmakers consider easing restrictions on public hospitals
    Biden COVID_i.jpg
    Biden to end COVID emergency declarations on May 11
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE +
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing