Person-Directed Care Means Quality Improvement: CMS Releases New Standards

September 24, 2014
Virgil Thomas,

The Centers for Medicare and Medicaid Services recently released data on its National Partnership to Improve Dementia Care campaign to reduce the unnecessary use of antipsychotic medication by people living with dementia.

CMS’s goals are laudable and their progress is heartening. Between the end of 2011 and the end of 2013, antipsychotic use in nursing homes was reduced by 15.1 percent. They are striving for a total reduction of 25 percent by 2015 and 30 percent by 2016.

The Eden Alternative is very proud to have been a part of this movement  to improve the lives of those living with dementia nationwide. We have conducted three, large state-based Dementia Beyond Drugs trainings in Tennessee, Kentucky, and MIssissippi, thanks to the support of CMP funds. Tennessee and Kentucky have shown remarkable improvement with 22.90 percent and 18.50 percent reductions respectively (the third training in Mississippi was not completed during the timeframe of the data released by CMS. Check out the full data report here.)

According to the CMS:

“We have created many tools for nursing homes to use to help achieve these goals,” said Dr. Conway. “Ultimately, nursing homes should re-think their approach to dementia care, re-connect with the person and their families, and use a comprehensive team-based approach to provide care.”

While the initial focus is on reducing the use of antipsychotic medications, the Partnership’s larger mission is to enhance the use of non-pharmacologic approaches and person-centered dementia care practices.

The news is so inspiring because it brings even more credence to that which so many people in the field already know; focusing on the person really works. It’s very hard to argue with the data. A national initiative, supported by a large coalition of partners, set a focus on reducing pharmaceuticals by simply replacing them with a new model of care. The result is reductions in every state nationwide.

Embracing person-directed care and focusing on culture change is the best way achieve quality improvement.

“More than ever, quality improvement in health care requires behavior change. The principles and practices of person directed care are providing us with the golden road to behavior change in healthcare systems,” says Dr. Bill Thomas.

CMS reported that in 2011 antipsychotic medication accounted for 8.4 percent of Part D spending totaling $7.6 billion. If they reach their 25% goal that is an annual saving of almost $2 billion annually. Imagine if that money was invested in education, behavior shaping, and person-directed care. Imagine the impact it would have on the full continuum of care. Imagine the impact on quality of care and quality of life for Elders across America.

Person-directed care is the most powerful tool anyone has to create and sustain long-term quality improvement efforts of any kind. To learn more about this, check out the 3-part feature webinar series, Person-Directed Performance Improvement, scheduled to launch October 16th.




2 Comments. Leave new

Thanks for highlighting the successes of this effort so far as well as the opportunities that still exist to go further. The incredible thing about culture change is that it is a never ending process. While that may seem a bit scary, it is also an incredible growth opportunity for long term care organizations and the people who live and work there.


This is so encouraging. So many decision makers never step foot into a long term care community. But these numbers will have an impact. Let’s just get them on desks, on the right desks!


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