Re-Boot Resident Care: Nonpharmacological Behavior Management Requires a Mindset Shift

By Caralyn Davis, Staff Writer - April 13, 2016

Nursing homes that don’t have a strong nonpharmacological behavior management program that targets the reduction of antianxiety medications (anxiolytics) and hypnotics, as well as antipsychotic medications, could one day find themselves in difficult waters with both state surveyors and potential residents who are savvy enough to navigate Nursing Home Compare.

The Centers for Medicare and Medicaid Services (CMS) has had its eye on residents who receive antipsychotic medications for a long time now through the publicly reported quality measures (QMs), Percent of Short-Stay Residents Who Newly Received an Antipsychotic Medication and Percent of Long-Stay Residents Who Received an Antipsychotic Medication. Since February 2015, these QMs have also been incorporated into the Five Star Quality Rating System.

Over the past few years, CMS has actively worked to get providers to reduce unnecessary antipsychotic medication use through the focused dementia care survey; the National Partnership for Dementia Care; and the 2013 issuance of revised guidance to surveyors in Appendix PP of the State Operations Manual for F-tag 309 (quality of care) related to residents with dementia and F329 (unnecessary drugs).

Now CMS is beginning to expand its focus to include antianxiety and hypnotic medications. The Percentage of Long-Stay Residents Who Received an Antianxiety or Hypnotic Medication is one of six new QMs that CMS will begin publicly reporting this month.