In March 2012, CMS introduced the National Partnership to Improve Dementia Care in Nursing Homes. A major component of the CMS initiative consisted of reducing the use of anti-psychotic medications in long term care residents with dementia nation-wide by 15 percent by the end of year 2012. During year 2013, it was announced that Kentucky was one of the first eleven states to achieve the CMS goal. Ultimately, the 15 percent reduction was met on a national basis and, by October, 2017, it was announced that nursing homes nation-wide had achieved a reduction of 35 percent! This astonishing success may be attributed to numerous factors including the adoption of the Hand-In-Hand Criteria, promotion of the concept of Culture Change, and acceptance of the position that Behavioral Interventions (aka, non-drug approaches) constitute the therapy of choice when responding to adverse behaviors associated with the various types of dementia.

 

For many years, long term care regulations have mandated that behavioral interventions be attempted or considered (unless clinically contraindicated) prior to utilizing antipsychotic medications to treat dementia-related behaviors. Following the great success of the CMS initiative and introduction of the new federal regulations in November 2017, the use of behavioral interventions is now mandated not just for antipsychotic use, but for all psychotropic medication classes, including antidepressants, anxiolytics, and sedative-hypnotics.

 

Several months ago, the Alzheimer's Association released an excellent, very well constructed article discussing the subject of dealing with dementia-related behaviors, titled BEHAVIORS: How to Respond When Dementia Causes Unpredictable Behaviors. The article provides suggestions on properly dealing with a variety of dementia-related behaviors such as physical/verbal aggression, agitation, wandering, insomnia, etc. It serves as a concise, easy-to-use primer on methods for applying behavioral interventions and, thus, obviating the need for psychotropic medications. The article should prove useful to both surveyors and caretakers alike, and the Office of Inspector General is grateful to the Alzheimer's Association for permission to reprint it in its entirety.

As of June 15, 2018, PBJ Users will no longer be able to submit PBJ data (XML files or online data entry) for staffing dates prior to January 1, 2018. Users can, however, review PBJ data for staffing dates prior to January 1, 2018, using CASPER reports. 

 

This change does not affect any of the deadline rules stated in the PBJ Policy Manual or online. Please see the PBJ Policy Manual for information about PBJ quarterly submission deadlines.

 

The QIES Technical Support Office (QTSO) Help Desk is available for technical support and assistance, if needed, and may be contacted by phone at 800-339-9313 or by email at  help@qtso.com.