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Center for Medicare Advocacy Discusses Nursing Home Resident Protections with CMS Administrator Seema Verma Did CMS’s Partnership to Improve Dementia Care Reduce the Inappropriate Prescribing of Antipsychotic Drugs for Nursing Home Residents as Much as CMS Claims? Two Recent Studies Say No Health Care Sabotage: Another Attempt at ACA Repeal Free Webinar: Enhancing the Promise … Read more

The Centers for Medicare & Medicaid Services (CMS) has ended its campaign to reduce the inappropriate use of antipsychotic drugs for long-stay residents in nursing facilities (formally called the National Partnership to Improve Dementia Care in Nursing Homes) for facilities that reduced their antipsychotic drug usage by 34% by the end of 2016 (from 23.9% … Read more

CMA Alert – Home Health Care Barriers; Overuse of Antipsychotic Drugs; More

Barriers to Home Care Created by CMS Payment, Quality Measurement, and Fraud Investigation Systems Elder Justice Alert: Human Rights Watch Publishes In-Depth Report on Antipsychotic Drug Use in U.S. Nursing Homes Consumer Statement on New Federal Landmark Study on “Critical Incidents” in Assisted Living Barriers to Home Care Created by CMS Payment, Quality Measurement, and … Read more

The Administration on Aging defines a subcategory of elder abuse – “physical abuse” – as “inflicting physical pain or injury on a senior, e.g. slapping, bruising, or restraining by physical or chemical means.”[1] Administering antipsychotic drugs to more than a quarter of a million nursing home residents meets the definition of elder abuse and, left … Read more

Last week’s Alert discussed the Centers for Medicare & Medicaid Services’ (CMS’s) National Partnership to Improve Dementia Care and the Government Accountability Office’s (GAO) recent report on antipsychotic drugs.[1]  The CMS Partnership and the GAO reported different numbers of nursing home residents receiving antipsychotic drugs.  Some of the differences appear to reflect the different databases … Read more

In September 2014, the Centers for Medicare & Medicaid Services (CMS)[1] reported that the National Partnership to Improve Dementia Care had reduced the use of antipsychotic drugs with nursing home residents by 15.1%, “exceeding” the Partnership’s 15% drug reduction goal for long-stay residents.  That claim of success was overstated.  When CMS originally announced the initial … Read more

As required by the 1987 federal Nursing Home Reform Law,[1] CMS has developed, tested, and periodically revised a survey protocol that state surveyors, who are generally employed by the state health departments, must use to determine nursing facilities' compliance with federal standards of care.  The survey protocol, which is composed of two Appendices to the … Read more

The Center for Medicare Advocacy (the Center) has reported on the misuse of antipsychotic drugs by nursing homes for many years, discussing Congressional hearings and federal reports and the high personal and financial cost of the misuse of the drugs.[1]  In December 2013, we reported on a study that the Center undertook with Dean Lerner … Read more

The misuse of antipsychotic drugs by nursing homes has been the subject of Congressional hearings and Government reports for many decades.[1]  More than 300,000 nursing home residents take antipsychotic drugs and, as the Inspector General found, most of the use violates federal law.[2]  With funding from the Commonwealth Fund of New York and in cooperation … Read more

The recent settlement of criminal and civil charges against Johnson & Johnson for off-label marketing of Risperdal for nursing home residents once again brings the issue of antipsychotic drugs and nursing homes to public attention.  A group of residents' advocates working to reduce the inappropriate use of antipsychotic drugs in nursing facilities recently issued a … Read more

November 14, 2013 For Immediate Release Statement of California Advocates for Nursing Home Reform, Center for Medicare Advocacy, Legal Aid Justice Center, Long Term Care Community Coalition, The National Consumer Voice for Quality Long-Term Care Washington, DC – The Department of Justice's $2.2 billion settlement with Johnson & Johnson over allegations that it illegally promoted … Read more

Examining Inappropriate Use of Antipsychotic Drugs, a Report in three Parts, looks at Survey and Certification deficiency citations for antipsychotic drug use in skilled nursing facilities (SNFs) and nursing facilities (NFs) from two perspectives.  First, it analyzes all of the approximately 300 antipsychotic drug deficiencies that were cited by seven states over a two-year period, … Read more

Examining Inappropriate Use of Antipsychotic Drugs, a Report in three Parts, looks at antipsychotic drug use in skilled nursing facilities (SNFs) and nursing facilities (NFs) from two perspectives.  First, it analyzes the antipsychotic drug deficiencies that were cited in seven states in calendar years 2010 and 2011 (Part One).  Second, in this Part, it reports … Read more

The misuse of antipsychotic drug is a pervasive problem in American nursing facilities.  Misuse causes physical and psychological harm and death to residents and costs many hundreds of millions of dollars annually,[1] both for the drugs themselves and in efforts to reverse the poor resident outcomes that are the common consequence of their misuse.  Examining … Read more

On May 31, 2012, the Centers for Medicare & Medicaid Services (CMS) announced an initiative to reduce the rampant misuse and overuse of antipsychotic drugs in nursing facilities.  The Center for Medicare Advocacy has been working to educate policy makers, advocates, and the public about the misuse of antipsychotic drugs for many years, and is … Read more

Introduction and Discussion (Attorney Toby Edelman's testimony at the Senate Aging Committee on Nov. 30, 2011) Articles and Updates Other Resources      The misuse of antipsychotic drugs as chemical restraints is one of the most common and longstanding, but preventable, practices causing serious harm to nursing home residents today.   We thank the Senate Special Committee on … Read more

April 18, 2012 Contact: Toby S. Edelman at (202) 293-5760 tedelman@medicareadvocacy.org The Center for Medicare Advocacy knows that huge savings in nursing facility costs, and advances in resident care, could be achieved if facilities eliminated the inappropriate use of antipsychotic drugs and provided sufficient staff to meet resident needs.  The Center commends the Senate Special … Read more

The Future of Long-Term Care: Saving Money by Serving Seniors Senate Special Committee on Aging April 18, 2012 2:00 p.m. Statement for the Record Toby S. Edelman Senior Policy Attorney Center for Medicare Advocacy 1025 Connecticut Avenue, NW, Suite 709 Washington, DC  20036 The Center for Medicare Advocacy suggests that huge savings in the cost … Read more

Contact: Toby S. Edelman at (202) 293-5760 tedelman@medicareadvocacy.org   Washington, DC – Advocates for nursing home residents who have been working for many years to eliminate all misuse of antipsychotic drugs for nursing home residents applaud the Centers for Medicare & Medicaid Services' (CMS's) new national initiative to address the drugging epidemic.  CMS's "National Initiative … Read more

Center Attorney Toby Edelman Testifies at Senate Aging Hearing About Overuse of Antipsychotic Drugs in Nursing Facilities Medicare Enrollment Period Ends December 7, 2011 January 2012 Brings Round 2 of CMS' Competitive Bidding Program for Suppliers of Durable Medical Equipment Orthotics And Supplies (DMEPOS) Center Attorney Toby Edelman Testifies at Senate Aging Hearing About Overuse … Read more

Report: Transfer and Discharge Deficiencies Cited Since 2017: Surveyors Focus On paperwork, Not Residents’ Rights Study Finds Link Between Registered Nurse Hours and Antipsychotic Drug Use Webinar: Skilled Nursing Facilities Update Report: Transfer and Discharge Deficiencies Cited Since 2017: Surveyors Focus On paperwork, Not Residents’ Rights The involuntary transfer and discharge of nursing home residents … Read more

Human Rights Watch (HRW) published a devastating report in February 2018, which found that over 179,000 nursing home residents were being administered off-label antipsychotic drugs every week.[1] Antipsychotic drugs are indicated to treat specific clinical conditions, such as schizophrenia, and not the behavioral symptoms of dementia. Nevertheless, the HRW report noted that most of the … Read more

On February 5, 2018, Human Rights Watch published an in-depth report on antipsychotic drug use in U.S. nursing homes. The Report, entitled “‘They Want Docile’: How Nursing Homes in the United States Overmedicate People with Dementia,” finds that over 179,000 nursing home residents are given off-label antipsychotic drugs every week.[1] The Report notes that most … Read more

July 26, 2013 Daniel R. Levinson Inspector General Department of Health and Human Services 330 Independence Avenue, SW Washington, DC 20201 Submitted Electronically Dear Mr. Levinson: A report today that your office has canceled plans to investigate antipsychotic drug use in nursing homes is disappointing and alarming. Two years ago we answered your challenge to … Read more

UNITED STATES SENATE SPECIAL COMMITTEE ON AGING OVERPRESCRIBED: THE HUMAN AND TAXPAYERS' COSTS OF ANTIPSYCHOTICS IN NURSING HOMES November 30, 2011 Testimony of Toby S. Edelman Senior Policy Attorney Center for Medicare Advocacy The misuse of antipsychotic drugs as chemical restraints is one of the most common and longstanding, but preventable, practices causing serious harm … Read more

Many nursing home residents who do not have a diagnosis that supports their taking antipsychotic medications are nevertheless given antipsychotic drugs.  These drugs are both dangerous to residents and extremely expensive for the Medicare program.   Reducing the use of antipsychotic drugs in nursing facilities would both dramatically improve the quality of care and quality of … Read more

Disclaimer: the views expressed in this Issue Brief and during the Alliance call are solely those of the Center for Medicare Advocacy. 1. UPCOMING ANNUAL COORDINATED ELECTION PERIOD (ACEP) Overview The Annual Coordinated Election Period (ACEP) – the period during which individuals with Medicare can make coverage elections for the following year – will start … Read more

Medicare Platform: Objective Information and Consumer Protections Face Challenges As Home Care Needs Increase, Access Issues Must Be Addressed Nursing Home Deregulation Continues, Despite Substantial Risk to Residents Medicare Platform: Objective Information and Consumer Protections Face Challenges At the beginning of the current session of Congress, the Center for Medicare Advocacy laid out a Medicare … Read more

September 2019 Background Under the Trump Administration, the Centers for Medicare & Medicaid Services (CMS) has been advancing efforts to deregulate the nursing home industry by rolling back the rights and protections of nursing home residents. These efforts include reducing accountability for substandard care, such as by shifting the default financial penalty for the most … Read more

Advocates Issue Joint Letter Raising Alarms about New Medicare Plan Finder and Revisions to MA and Part D Marketing Guidelines CMS Proposed Medicare Home Health Rules Raise Concerns for Access to Care – Comments due September 9, 2019 Stop Drugging Nursing Home Residents Without their Written Consent Advocates Issue Joint Letter Raising Alarms about New … Read more

Background. Nursing homes administer antipsychotic drugs to approximately 20 percent of residents nationwide. Sadly, and too often, nursing homes use these drugs as a way of chemically restraining residents exhibiting the behavioral symptoms of dementia, despite the Food and Drug Administration’s (FDA) “black box” warning against using antipsychotic drugs on elderly patients with dementia. The … Read more

Alexander v. Azar Trial Update – Seeking an Appeal of Outpatient Observation Status CMS Could Truly Put “Patients over Paperwork” By Fully Implementing the Jimmo Settlement Comparing Spending on Medicare Advantage vs. Accountable Care Organizations (ACOs) Recorded Webinar: Proposed Changes to Nursing Home Standards Alexander v. Azar Trial Update – Seeking an Appeal of Outpatient Observation Status … Read more

The Centers for Medicare & Medicaid Services (CMS) recently issued a notice of proposed rulemaking to roll back several nursing home standards of care. The Long Term Care Community Coalition (LTCCC) hosted a webinar on August 20, 2019, to help consumers understand the impact of these proposed changes. Dara Valanejad, a Policy Attorney at both … Read more

CMS’s Proposed Changes to Nursing Home Requirements of Participation, Survey and Enforcement: Nothing Good for Residents Federal Reports Find Incidents of Nursing Home Resident Abuse Are on the Rise but also Underreported Self-Help Resources for Improvement Standard Denials – August, 2019 CMS’s Proposed Changes to Nursing Home Requirements of Participation, Survey and Enforcement: Nothing Good … Read more

Although the revised Requirements of Participation published in October 2016[1] have not yet been fully implemented, the Centers for Medicare & Medicaid Services (CMS) published proposed rules on July 18, 2019 to revise them and also to make changes in survey and enforcement rules.[2]  CMS contends that its proposals are intended to “promote efficiency and … Read more

Part D Legislation Markup Today: Improve Beneficiary Appeals CMS Releases Special Focus Facility Candidate List But Transparency Issues Remain Senate Finance Committee Holds Hearing on Nursing Home Issues Private Medicare Advantage Plans Overbill Medicare Part D Legislation Markup Today: Improve Beneficiary Appeals On Tuesday, July 23, the Senate Finance Committee released draft drug pricing legislation, … Read more

On July 23, 2019, the Senate Finance Committee held its second nursing home hearing this year, “Promoting Elder Justice: A Call for Reform,”[1] following its March 6 hearing “Not Forgotten: Protecting Americans from Abuse and Neglect in Nursing Homes.”[2]  The Center for Medicare Advocacy is pleased that the July 23 hearing included a national advocate … Read more

1. UPDATES on the BENES Act and PART D LEGISLATION Guest Speaker:  Lindsey Copeland from the Medicare Rights Center Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act (S. 1280/H.R. 2477) Medicare Rights Center one-pager – https://www.medicarerights.org/pdf/2019-benes-act-factsheet-long.pdf Medicare Watch article, The BENES Act Advances in the House – https://blog.medicarerights.org/benes-act-advances-in-the-house/ Medicare Watch article, MedPAC Calls for Improvements in Medicare … Read more

NOT FORGOTTEN: PROTECTING AMERICANS FROM ABUSE AND NEGLECT IN NURSING HOMES Hearing held March 6, 2019 Statement for the record submitted by:  Tony Chicotel, Staff Attorney; Michael Connors, Long Term Care Advocate; Janet Wells, Public Policy Consultant California Advocates for Nursing Home Reform 650 Harrison Street, #2 San Francisco, CA  94107 www.canhr.org Toby Edelman, Senior … Read more

United States Senate Committee on Finance “Not Forgotten: Protecting Americans From Abuse and Neglect in Nursing Homes” March 6, 2019 Statement submitted by: Long Term Care Community Coalition, Center for Medicare Advocacy, National Consumer Voice for Quality Long-Term Care, Justice in Aging, California Advocates for Nursing Home Reform, and National Academy of Elder Law Attorneys … Read more

January 25, 2018 Submitted via www.regulations.gov Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-4180-P Re: CMS-4180-P: Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses The Center for Medicare Advocacy (Center) submits the following comments in response to the Centers for Medicare & Medicaid … Read more

Disclaimer: the views expressed in this Issue Brief and during the Alliance call are solely those of the Center for Medicare Advocacy. ACCESS TO CARE    Home Health Between April 2017 and October 2018, the Center completed the “CMA Issue Brief Series: Medicare Home Health Crisis” – a ten-part series examining the growing crisis in … Read more

More Health Care Sabotage: Inadequate Funding for Navigators Court Ruling May Lead to Even More Overpayments to Medicare Advantage MedPAC Discusses Requiring a Three-Day Hospital Stay for All Post-Acute Care, Threatening Access to Care House Committee Holds Hearing on Nursing Home Quality Issues Proposed DMEPOS Rules: Clarification and Enforcement Needed More Health Care Sabotage: Inadequate … Read more

For the first time in many years, Congress held a hearing on nursing home quality of care on September 6, 2018.  The hearing of the Subcommittee on Oversight and Investigations of the House Energy and Commerce Committee, entitled “Examining Federal Efforts to Ensure Quality of Care and Resident Safety in Nursing Homes,” featured three witnesses: … Read more

Seema Verma, the Administrator of the Centers for Medicare & Medicaid Services (CMS), invited the Center for Medicare Advocacy and other advocacy organizations to meet with her on June 25, 2018. The Administrator asked our organizations to provide one to two recommendations for the Requirements of Participation that would reduce burdens on nursing facilities. However, … Read more

A message from the Center for Medicare Advocacy and the Long Term Care Community Coalition: June 15th is World Elder Abuse Awareness Day. According to the Administration for Community Living (ACL), about five million – one in ten – older adults are abused, neglected, or exploited every year. Elder abuse can take many forms and may … Read more

Medicare Trustees Report: Stop Overpaying Private Plans & Underfunding Medicare The Right Way to Lower Medicare Prescription Drug Costs Medicare Prior Authorization Requirement for Power Wheelchairs Expanding Nationwide Effective September 1, 2018 Center for Medicare Advocacy Emphasizes Need to Protect Nursing Home Residents at Congressional Briefing Medicare Trustees Report: Stop Overpaying Private Plans & Underfunding … Read more

On June 4, 2018, the House of Representatives Democratic Caucus Seniors Task Force held a briefing on “Protecting Seniors by Improving – Not Eroding – Nursing Home Quality Standards.” The Center for Medicare Advocacy, led by Senior Policy Attorney Toby Edelman, presented on the enforcement of the nursing home standards, as well as the current … Read more

CMA Alert – Bill Jeopardizes Civil Rights of People with Disabilities; More

House Passes Bill Jeopardizing Civil Rights of Individuals with Disabilities Medicare Home Health Highlight Latest Nursing Home Rights Issue Alert This Week in Healthcare Sabotage House Passes Bill Jeopardizing Civil Rights of Individuals with Disabilities 5th Annual National Voices of Medicare Summit & Sen. Jay Rockefeller Lecture This year's Summit will focus on health care … Read more

The Long Term Care Community Coalition (LTCCC), in partnership with the Center for Medicare Advocacy, publishes monthly Issue Alerts on the rights of nursing home residents. These Issue Alerts focus on specific standards of care that nursing homes must follow as a requirement of participating in Medicare and Medicaid. The goal of this project is … Read more