Karen Tritz, MSW, is the Director of the Nursing Homes Division within the Survey and Certification Group at the Centers for Medicare & Medicaid Services’ (CMS) Center for Clinical Standards and Quality. She is responsible for implementing the national quality standards for nursing homes that participate in Medicare and Medicaid through the survey and certification process. Previously, Tritz served as the Technical Director for Organ Transplantation at CMS. She earned a Master of Social Work from Washington University in St. Louis and a Bachelor of Social Work from the University of Wisconsin-Eau Claire.
Q. Tell us about your role in the National Partnership to Improve Dementia Care in Nursing Homes and how your background in social work has prepared you for this role.
As the Director of CMS’ Division of Nursing Homes, I work closely with staff to implement the National Partnership, including conducting focused surveys, supervising many of our activities and holding calls with providers. My background in social work has prepared me well for this role. Every student of social work learns that you focus on individuals from where they are starting and build on their strengths. Like other individuals, I have personal experience with dementia in my family and know that people shouldn’t be defined by their disease. You need to get to know them, their likes and dislikes, and build an environment and culture that supports them.
Q. For those who aren’t familiar with the Partnership, could you please provide a high-level overview of its purpose and goals?
The Partnership is a public-private collaboration that seeks to enhance the quality of care and life for people with dementia. CMS established the Partnership in 2012, at a time when nearly one-quarter of nursing home residents were on antipsychotic drugs. There were a variety of safety concerns about their usage. The Partnership brought together federal and state agencies, providers, advocacy groups and families to address this pressing issue. While the primary focus of the Partnership has been to reduce antipsychotic drug usage, its overall goal is to create a supportive environment of person-centered care for residents.
Q. The Partnership surpassed its 2015 goal of achieving a 25 percent reduction in antipsychotic medication use in long-stay nursing home residents. How is the Partnership tracking toward its 2016 goal of a 30% reduction?
By March 31, 2016, the Partnership had achieved a 30.3% reduction in antipsychotic medication use, equating to a national prevalence rate of 16.6%. These results surpassed the original goal we set for calendar year 2016. We are elated that the rate has gone down significantly.
Q. In what ways are QIN-QIOs collaborating with the Partnership?
Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) are central partners. Each state has its own dementia care coalition, and in 29 states, the coalition is led by the QIN-QIO representing that state. QIN-QIOs have worked hard to highlight our federal activities, developed a variety of materials and held workshops. We also are working closely with Telligen, the QIN-QIO for Colorado, Illinois and Iowa, on the National Nursing Home Quality Improvement Campaign website, which houses easily accessible resources and tools developed by the Partnership.
Q. Can you give us a sense of what your goals or priorities will be in 2017?
We are planning to continue with the Partnership, so we will be talking with all stakeholders and then setting and announcing new goals for 2017. While we are pleased with the progress in antipsychotic medication reduction, more can be done. Some nursing homes across the country have worked very hard to enhance their dementia care and reduce antipsychotic usage. We want that to be the norm throughout the long-term care community. The Partnership will continue supporting state dementia care coalitions, conducting focused surveys, hosting Medicare Learning Network provider calls and other activities.
There are two primary websites where individuals can access information and resources. The National Partnership page on the CMS website contains a lot of research from focused surveys and interim reports, while National Nursing Home Quality Improvement Campaign website has a variety of resources for nursing homes, care providers and family members, including handouts, presentations, tools and fact sheets.
Q. Anything else you would like QIO News readers to know?
Above all, I would like to thank the QIN-QIOs for being such great partners, particularly for their leadership of state coalitions, technical assistance to nursing home providers, and conducting of workshops on critical topics like nursing home staffing and improving dementia care.