Background When the Centers for Medicare & Medicaid Services (CMS) launched a national campaign to reduce the off-label prescribing of antipsychotic drugs for nursing home residents in 2012, Avanir Pharmaceuticals directed its sales force to talk to nursing facilities about using Nuedexta as a substitute for antipsychotic drugs. The Food and Drug Administration had approved … 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

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

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

Revelations have shed light on an opioid crises in the United States that remained largely hidden until recently. These drugs have affected the lives of children and adults nationwide. Unfortunately, the inappropriate use of medication – legally or illegally – is not limited to opioids in its multigenerational reach. As the New York Times reports … 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

CMA Alert, October 18, 2017 – Nursing Home Rights Roundup; ACA Stabilization; 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

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

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

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

Medicare beneficiaries are being denied access to Medicare’s skilled nursing facility (SNF) benefit because acute care hospitals are increasingly classifying their patients as “outpatients” receiving observation services, rather than admitting them as inpatients.  Patients are called outpatients despite the fact that they may stay for many days and nights in hospital beds and receive medical … Read more

PROGRAM INTEGRITY: OVERSIGHT OF RECOVERY AUDIT CONTRACTORS United States Senate Committee on Finance Hearing June 25, 2013 Statement Submitted by the Center for Medicare Advocacy, Inc. The Senate Finance Committee’s June 25 hearing on the Recovery Audit Contractors (RACs) program highlights the high financial costs that the RAC program has imposed on acute care hospitals … 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

April 18, 2012 Contact: Toby S. Edelman at (202) 293-5760 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