Quality of care

Proposed dementia care guidance released by CMS

On May 24, the Centers for Medicare & Medicaid Services (CMS) released a memo sent to state survey agency directors that contained interim guidance related to surveyors’ assessment for compliance with requirements related to nursing home residents with dementia and unnecessary drug use.

These updates include sampling for the traditional survey process in Appendix P.  In Appendix P, CMS has made changes to the resident sampling process for the traditional survey (changes to QIS were included in the recent 10.1.3 release). The change is intended to ensure that the survey sample includes an adequate number of residents with dementia who are receiving an antipsychotic medication.

On March 29, 2012, CMS launched the National Partnership to Improve Dementia Care and Reduce Unnecessary Antipsychotic Drug Use in Nursing Homes (this is now referred to as the Partnership to Improve Dementia Care in Nursing Homes).

The goal of this partnership is to optimize the quality of life and function of residents in America’s nursing homes by improving approaches to meeting the health, psychosocial and behavioral health needs of all residents, especially those with dementia.

Fundamental principles of care for a resident with dementia include an interdisciplinary approach that focuses on the needs of the resident as well as the needs of the other residents in the nursing home.

Sections 1819 and 1919 of the Social Security Act (the Act) and current regulations already require a number of essential elements to be in place in order for facilities to be in compliance with federal requirements on quality of care and quality of life

This revised CMS guidance and surveyor training highlight and re-emphasize a number of key principles, including:

  1. Person–Centered Care
  2. Quality and Quantity of Staff
  3. Thorough Evaluation of New or Worsening Behaviors
  4. Individualized Approaches to Care
  5. Critical Thinking Related to Antipsychotic Drug Use
  6. Interviews with Prescribers
  7. Engagement of Resident and/or Representative in Decision-Making

Read the memo to learn more about the guidance issued to surveys and see the changes in full.