Online Program

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

Monday, November 4, 2013 : 11:30 a.m. - 11:42 a.m.

Alice Bonner, PhD, RN, Office of Clinical Standards and Quality, US Department of Health and Human Services, Baltimore, MD
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.

Learning Areas:

Clinical medicine applied in public health
Other professions or practice related to public health
Provision of health care to the public
Public health or related nursing
Public health or related public policy

Learning Objectives:
Describe how health care reform may affect the health of the elderly. Identify how to link the public health and prevention approaches to clinical care in work with the elderly. Discuss the ways that Centers for Medicare and Medicaid Services (CMS) developed training for direct care workers (nursing assistants) on two topics: how to prevent abuse of elders and how to care for nursing home residents with dementia. Analyze innovative and evidence-based approaches that are currently being used for work with elderly people.

Keyword(s): Elderly, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was an official in the Centers for Medicare and Medicaid and oversee the section that insures that patients receive the highest quality care when they are in a nursing home or rehabilitation facility. In the role I have overseen new prioritized practices and models of care that are being implemented around the country to reduce falls and inappropriate use of medications of the elderly in the home and in clinical settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.