July 17, 2014_NH "Dear Administrator" Letters

July 17, 2014
ALTSA:  NH 2014-009

Dear Nursing Facility/Home Administrator:

On June 30, 2014, Dr. Elinore F. McCance-Katz, M.D., Ph.D., Chief Medical Officer for the Substance Abuse and Mental Health Services Administration (SAMHSA), issued a letter on behalf of SAMSHA warning about the use of antipsychotic prescription medication for vulnerable adults diagnosed with dementia and living in nursing home facilities. This letter describes the adverse events that may occur as a result of this practice, other conditions that may explain distressed or disruptive behaviors, and alternative approaches that may help to reduce or eliminate antipsychotic use.

The department encourages providers to fully align their facilities to support the implementation of nursing home facility Quality Assurance programs and corresponding Care Plans in their facilities. These program and plans have been designed to minimize the use of and/or to otherwise ensure only appropriate antipsychotic drug use by vulnerable adults who have been diagnosed with dementia and are living in a nursing home.

As part of the facility's Quality Assessment and Assurance Committee, the clinical staff, including the medical director, the administrator, pharmacist, and director of nursing, should assist the facility with a review of the processes of care for those residents with behavioral and psychological symptoms related to dementia on antipsychotic medications.

You can review the June 30, 2014 SAMSHA letter on the internet at: 


Thank you for your continued commitment to nursing home residents.  If you have any questions, please contact your RCS Field Manager.           


Carl I. Walters II., Director
Residential Care Services