03/19/2026

Did You Know? Updated Long-Stay Antipsychotic Use Quality Measure

In response to long-standing concerns from the Office of Inspector General (OIG) and other stakeholders about the unnecessary use of antipsychotic medications and potential for underreporting via the MDS dataset, CMS has revised (in effect January 1, 2026) how it calculates the long-stay antipsychotic use quality measure for nursing homes. 

The new 'hybrid' calculation incorporates Medicare and Medicaid claims data to validate and augment reported usage rates from the MDS dataset collection process. Review this HealthDirect Pharmacy Services, a LeadingAge Ohio Partner, “Did You Know?” article on the updated quality measure that provides actionable details on how to audit and improve your antipsychotic usage rates, as reflected by the new quality measure methods. CMS is reportedly reviewing this policy with the goal of supporting clinically indicated use while continuing to discourage inappropriate prescribing.