Improving dementia care and reducing unnecessary antispychotic medication use: Health care reform

The Affordable Care Act provides a number of initiatives to promote health care quality specific to nursing home residents. Under Section 6102, nursing homes are required to develop and implement a system-wide plan for Quality Assurance Performance Improvement or QAPI one year after the rule is promulgated. This has the potential to truly transform the way in which care and services are provided in the nation's 15,800 nursing homes. The intent is to create a culture of safety and quality and for nursing homes to become learning organizations. Under Section 6121 of the Affordable Care Act, CMS was charged with developing training for direct care workers (nursing assistants) on two topics: how to prevent abuse and how to care for residents with dementia. The training, a series of six DVDs and an instructor manual called "Hand in Hand" was distributed to every nursing home in the country in 2012. This program is a critical component of the National Partnership to Improve Dementia Care and Reduce Unnecessary Antispychotic Medication Use, a public-private partnership led by CMS that has created state coalitions in every state. Many state departments of public health, survey agencies, Medicaid agencies, AAAs, ombudsman and others are working together toward the same goal of reducing the rate of antipsychotic use in nursing homes by at least 15%. Substantial progress toward that goal has been reported - data is reported quarterly on Nursing Home Compare.