Federal Government Rarely Penalizes Nursing Homes for Overusing Antipsychotic Drugs

Although the federal government began a campaign in 2012 to get nursing homes to reduce their use of antipsychotic drugs, it rarely penalizes institutions that continue to use the drugs at high rates, NPR reports.

These drugs, designed to treat people with serious mental illnesses such as schizophrenia or bipolar disorder, can be deadly for older people with Alzheimer’s or other forms of dementia. Despite this risk, almost 300,000 nursing home residents across the country are given antipsychotic medications, according to the article.

In Texas, more than one-quarter of nursing home residents are given antipsychotic drugs, compared with a nationwide average below 20 percent. The state has conducted a series of trainings for nursing home employees to teach them about alternatives to giving residents antipsychotic medications. Employees are encouraged to learn enough about residents to determine why they exhibit challenging behaviors, and to find ways to deal with these behaviors without antipsychotic drugs.

One example is allowing a resident who used to be a night watchman to continue roaming the halls at night, instead of sedating him to make him conform to the sleeping schedule of the rest of the residents.

NPR analyzed federal government data and found that although Texas nursing homes have the highest rate of antipsychotic drug use in the nation, they are less likely to be censured for it than institutions in most other states.

Toby Edelman, a senior policy attorney with the Center for Medicare Advocacy, says the government needs to enforce the Nursing Home Reform Act, which says residents have the right to be free from “chemical restraints.” The law, passed 27 years ago, also says residents should only receive antipsychotic drugs if they are medically necessary.

According to NPR’s analysis of data from the Centers for Medicare and Medicaid Services, stiff penalties are almost never used when nursing home residents receive any type of unnecessary drug.