{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:44:41Z","timestamp":1783053881086,"version":"3.54.6"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K08 AG071856"],"award-info":[{"award-number":["K08 AG071856"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K23AG066864"],"award-info":[{"award-number":["K23AG066864"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P01 AG027296"],"award-info":[{"award-number":["P01 AG027296"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG065722"],"award-info":[{"award-number":["R01AG065722"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG077620"],"award-info":[{"award-number":["R01AG077620"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Federal policies targeting antipsychotic use among nursing home (NH) residents may have increased reporting of diagnoses for approved uses, including schizophrenia, Tourette's syndrome, and Huntington's Disease (called \u201cexclusionary diagnoses\u201d because they exclude residents from the antipsychotic quality metric). We assessed changes in new exclusionary diagnoses among long\u2010stay NH admissions specifically with dementia following federal policies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective, quarterly, interrupted time\u2010series analysis (2009\u20132018) of new long\u2010stay NH residents with dementia and no exclusionary diagnoses reported before NH admission. The National Partnership and the addition of facility level antipsychotic use to the Five Star Quality Rating system were key time exposures. Outcome was quarterly facility level predicted percentage of exclusionary diagnoses within 2\u2009years of admission stratified by NH characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For 264,095 long\u2010stay admissions, mean percentage of new exclusionary diagnoses was 2.2% before the Partnership. After the Partnership, there was an unadjusted increase in the percentage over time (slope change, 0.044,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018), but the percentage never exceeded 2.9%. The Partnership contributed to a one\u2010time decrease in diagnoses in NHs with an intermediate percentage of Black residents (\u22121.29%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). Before the Partnership, diagnoses were increasing among not\u2010for\u2010profit relative to for\u2010profit NHs (0.044;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012), but after the Partnership, the pattern reversed. For\u2010profit NHs saw an increase (+0.034,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002); not\u2010for\u2010profit NHs experienced a decrease (\u22120.014,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039). Quality Rating modifications had no significant effect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Exclusionary diagnosis reporting among long\u2010stay NH residents with dementia, the group most at risk from antipsychotics, did not increase in response to federal policies. Evaluation of reasons for the observed increase in exclusionary diagnoses among non\u2010dementia NH residents is warranted along with continued attention to how to incentivize the appropriate use of medications in residents with dementia that is crucial for high\u2010quality NH care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19129","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T09:02:08Z","timestamp":1724403728000},"page":"3742-3752","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of federal antipsychotic use policy in nursing homes on new diagnoses for approved indications in dementia residents"],"prefix":"10.1111","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6846-8783","authenticated-orcid":false,"given":"Theresa I.","family":"Shireman","sequence":"first","affiliation":[{"name":"Center for Gerontology and Healthcare Research Brown University School of Public Health  Providence Rhode Island USA"},{"name":"Department of Health Services, Policy, and Practice Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neto","family":"Coulibaly","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for Gerontology and Healthcare Research Brown University School of Public Health  Providence Rhode Island USA"},{"name":"Department of Health Services, Policy, and Practice Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1673-4570","authenticated-orcid":false,"given":"Andrew R.","family":"Zullo","sequence":"additional","affiliation":[{"name":"Center for Gerontology and Healthcare Research Brown University School of Public Health  Providence Rhode Island USA"},{"name":"Department of Health Services, Policy, and Practice Brown University School of Public Health  Providence Rhode Island USA"},{"name":"Department of Epidemiology Brown University School of Public Health  Providence Rhode Island USA"},{"name":"Center of Innovation in Long\u2010Term Services and Supports Providence Veterans Affairs Medical Center  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1943-0150","authenticated-orcid":false,"given":"Lauren B.","family":"Gerlach","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5723-0443","authenticated-orcid":false,"given":"Antoinette B.","family":"Coe","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Clinical Pharmacy, College of Pharmacy University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori A.","family":"Daiello","sequence":"additional","affiliation":[{"name":"Center for Gerontology and Healthcare Research Brown University School of Public Health  Providence Rhode Island USA"},{"name":"Department of Health Services, Policy, and Practice Brown University School of Public Health  Providence Rhode Island USA"},{"name":"Department of Neurology, Warren Alpert Medical School Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick","family":"Lo","sequence":"additional","affiliation":[{"name":"Center for Gerontology and Healthcare Research Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1481-4462","authenticated-orcid":false,"given":"Julie P. W.","family":"Bynum","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Internal Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,23]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"National Nursing Home Quality Improvement Campaign.Healthcare quality improvement campaign. February 27 2019.https:\/\/www.nhqualitycampaign.org\/"},{"key":"e_1_2_11_3_1","unstructured":"Centers for Medicare & Medicaid Services (CMS).National Partnership to Improve Dementia Care in Nursing Homes: Antipsychotic Medication Use Data Report (April 2022). Updated July 29 2022. Accessed July 25 2023.https:\/\/www.cms.gov\/files\/document\/antipsychotic-medication-use-data-report-2021q4-updated-07292022.pdf"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2021.10.008"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17464"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/07317115.2017.1395378"},{"key":"e_1_2_11_7_1","unstructured":"ThomasK GebeloffR Silver\u2010GreenbergJ.Phony diagnoses Hide high rates of drugging at nursing homes. 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