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 →

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 →

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 →

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 →

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 →

Tax Cut Bill Just Got Worse. Health Care at Risk. This Week in Sabotage CMS Steering to Medicare Advantage Administration And Nursing Home Industry: Lockstep in Deregulating Nursing Facilities & Reducing Resident Protections Tax Cut Bill Just Got Worse.  Health Care at Risk. Free Webinar Series Next Webinar: Hospital Observation Status Update January 24, 2018 … Read more →

This Week in ACA Sabotage Bipartisan Agreement on ACA Stabilization Package Nursing Home Rights Roundup CMS Signals End of Campaign to Reduce Unnecessary Use of Antipsychotic Drugs In Nursing Homes; Claim of Success is Grossly Overstated OIG Report about Nursing Home Complaints Leaves Questions Unanswered Congressional Letter Asks for Revision and Delay of Nursing Home … Read more →

HHS OIG Warns of Potential Elder Abuse in Skilled Nursing Facilities Connecticut State Senator Ted Kennedy, Jr. Joins Center for Medicare Advocacy Advisory Board Jimmo Corrective Action Plan Completed HHS OIG Warns of Potential Elder Abuse in Skilled Nursing Facilities Last week, the HHS Office of Inspector General (OIG) issued an Early Alert, warning of … Read more →

As noted in a previous Alert, the Center for Medicare & Medicaid Services (CMS) recently finalized their 2018 Call Letter.  In the same document, CMS issued a Request for Information regarding ideas for “regulatory, sub-regulatory, policy, practice and procedural changes to better accomplish” the goals of “using transparency, flexibility, program simplification and innovation to transform … Read more →

April 24, 2017 VIA ELECTRONIC SUBMISSION PartCDcomments@cms.hhs.gov Seema Verma, Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Baltimore, MD 21244 Re:                  2017 Transformation Ideas – Response to Request for Information re: Medicare Advantage and Part D Dear Administrator Verma: The Center for Medicare Advocacy (Center) is pleased to provide … Read more →

Mandating specific levels of direct care nursing staff would seem to be a straightforward method to improve staffing in nursing facilities.  If more nursing staff are needed, why not simply require facilities to employ more nurses?  The strategy is far more complex, however, than it at first appears.  This paper reviews which states have tried … Read more →

March 3, 2017 VIA ELECTRONIC SUBMISSION AdvanceNotice2018@cms.hhs.gov Cynthia G. Tudor, Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Baltimore, MD 21244 Re:  Advance Notice of Methodological Changes for Calendar Year 2018 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2018 Call Letter Dear … Read more →

January 13, 2017 – WASHINGTON – On January 18, 2017 U.S. Rep. Tom Price (R – Ga.) will face a hearing before the Senate Health, Education, Labor and Pensions Committee to determine his qualification to become Secretary of Health and Human Services. Details are pending regarding an additional hearing before the Senate Finance Committee. Medicare … Read more →

MOVING FORWARD WITH HOPE It’s no surprise that the election has left many of us worried and disoriented.  But we’ll regroup. We may not understand where we’ve landed, but we’ll acclimate and march forward – with hope. We hope the new administration will realize how today’s families are balancing – often barely – all the … Read more →

For Immediate Release Contact: Toby S. Edelman, Senior Policy Attorney TEdelman@MedicareAdvocacy.org, (202) 293-5760 The Centers for Medicare & Medicaid Services has just released a comprehensive revision of federal nursing facility regulations.   The regulations and explanatory material (over 700 pages total) are available here.  The positives for nursing facility residents include expanded training requirements, and a … Read more →

Under the federal Nursing Home Reform Law, the Centers for Medicare & Medicaid Services (CMS) has authority and the “responsibility”[1] to impose Civil Money Penalties (CMPs) and other enforcement actions at nursing homes that are found to violate federal standards of care (which are called Requirements of Participation).[2]  For the first time in more than … Read more →