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Project PAUSE Submits Comments on Quality Measurement in Nursing Facilities

Published June 9, 2021

June 9th 2021 – On Monday, June 7, the Project PAUSE (Psychoactive Appropriate Use for Safety and Effectiveness coalition submitted a public comment letter to the Centers for Medicare and Medicaid Services (CMS) regarding quality measures under consideration in skilled nursing facilities (SNFs).

In the proposed rule, the “Percentage of Long-Stay Residents who got an Antipsychotic Medication” quality measure was cited for potential inclusion in an upcoming expansion of the SNF value-based purchasing program. Ensuring appropriate care for patients with dementia is essential. However, this measure has been critiqued for being inaccurate and not supporting clinical best practices.

In the comment letter, Project PAUSE provided detailed feedback and stated:

  • Measuring inappropriate use of antipsychotics is important. However, the current antipsychotic medication use measure does not provide accurate information on the quality or value of care.
  • Continued reliance on the measure without modifications could result in worse patient outcomes, increase health inequities, and cause preventable patient harm.
  • CMS should revise the measure to require ongoing multidisciplinary review of patient use of antipsychotics and enhanced documentation to support CMS’s ability to assess and investigate inappropriate prescribing practices.

The following members of Project PAUSE signed the letter to CMS:

  • Alliance for Aging Research
  • AMDA – The Society for Post-Acute and Long -Term Care Medicine
  • American Association for Geriatric Psychiatry
  • American Association of Post-Acute Care Nursing (AAPACN)
  • American Society of Consultant Pharmacists
  • Caregiver Action Network
  • National Community Pharmacists Association
  • National Minority Quality Forum
  • The Gerontological Society of America

About the Alliance for Aging Research

The Alliance for Aging Research is the leading nonprofit organization dedicated to accelerating the pace of scientific discoveries and their application to vastly improve the universal human experience of aging and health. The Alliance believes advances in research help people live longer, happier, more productive lives and reduce healthcare costs over the long term. For more than 30 years, the Alliance has guided efforts to substantially increase funding and focus for aging at the National Institutes of Health and Food and Drug Administration; built influential coalitions to guide groundbreaking regulatory improvements for age-related diseases; and created award-winning, high-impact educational materials to improve the health and well-being of older adults and their family caregivers. For more information, visit

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