Despite a campaign by the federal government to get nursing homes to stop overmedicating residents, National Public Radio reports that the abuse of antipsychotics to restrain residents continues. It turns out regulators rarely fine homes for this abuse, which leaves them free to continue the practice.
Last year, the Boston Globe reported that antipsychotic overuse is prevalent in many of the country’s nursing homes, and that in 2010, about 185,000 residents were given the drugs without a valid reason. The Globe reported, “Documents obtained under the Freedom of Information Act revealed that in 21 percent of US nursing homes that year, at least one-quarter of the residents without illnesses recommended for antipsychotic use received the medications.”
Antipsychotic drugs are helpful for people with serious mental illnesses like bipolar disorder and schizophrenia. The drugs are not approved to treat symptoms of dementia. NPR writes, “For older people with Alzheimer’s or other forms of dementia, they can be deadly. The Food and Drug Administration has given these drugs a black box warning, saying they can increase the risk of heart failure, infections and death. Yet almost 300,000 nursing home residents still get them.”
Despite the federal government’s 2012 push to get homes to end overuse of antipsychotics, records show that regulators rarely give any penalties to homes that continue their use.
The federal Centers for Medicare and Medicaid Services say they are in a “partnership” with nursing homes and working to educate them. Yet a nursing home ombudsman in Texas told NPR she has offered to conduct on-site training at nursing homes and less than 10 out of nearly 100 homes in her county elected to participate.
In Massachusetts, the Boston Globe found that from 2009-2011, only 27 homes were cited for unnecessary use of antipsychotics.
In the Massachusetts cases where homes were cited, “inspection reports described residents who had been on antipsychotics for months, and sometimes years, without evidence that staff tried to wean them off — as required by federal law. And a few reports detailed instances in which residents were so overmedicated they were unable to open their mouths to eat, or do much of anything besides sleep.”
In none of those cited incidents did the inspector deem the problem as serious, and none of the homes were fined.
A policy attorney with the Center for Medicare Advocacy told NPR that there is a law on the books that the government could enforce. It’s the Nursing Home Reform Act passed two decades ago, which states that residents have a right to be free from chemical restraints. It also states that antipsychotics should only be given when medically necessary.