New Data Released By the OIG Indicates Failure to Decrease Psychotropic Drug Use in Nursing Homes

On November 14, 2022, the Office of Inspector General (OIG) from the Department of Health and Human Services released a report in partnership with the Centers for Medicare & Medicaid Service (CMS) showing that 80% of Medicare patients in long-term nursing homes were prescribed psychotropic drugs, despite efforts to decrease psychotropic drug use. 

The data collected for this study was compiled in response to quality and safety concerns raised by the OIG in 2011 about psychotropic drug use, specifically in the antipsychotic category. According to the National Library of Medicine, psychotropic is a broad term to classify medications that affect mental function, behavior, and experience. They are typically used to treat adults suffering from mental illnesses that cause symptoms of anxiety, depression, psychological distress, and/or insomnia.

In 2012, CMS began monitoring the use of psychotropic drugs in nursing homes to address speculation from governing agencies and lawmakers that these medications were being used inappropriately to chemically subdue or restrain nursing home residents. CMS focused its efforts on reducing the use of antipsychotic drugs, a category of psychotropics. 

After nearly a decade of efforts, this new report discovered that even though antipsychotic drug use declined, anticonvulsant use increased. The result was an overall similar rate of psychotropic drug use as nearly a decade earlier.  

In addition, the OIG report discovered that: 

• Lower ratios of trained nursing staff to residents at the facility were associated with higher psychotropic drug use. 
• Nursing homes with higher percentages of residents with low-income subsidies were also associated with higher use of psychotropic drugs.
• The number of residents taking drugs for schizophrenia without a corresponding diagnosis in their Medicare claims increased by 194%.
• There were 99 nursing homes with 20% or more of their residents taking drugs for schizophrenia who were unsupported by a schizophrenia diagnosis. 
• Flaws in CMS reporting structure leave room for nursing homes to misreport resident schizophrenia diagnoses and falsely impact data. 

3 Recommendations from OIG

In response to the findings of this report, OIG made recommendations to CMS to improve reporting measures and their efforts to reduce psychotropic drug use. 

1. Evaluate the use of psychotropic drugs to determine if additional action is needed to ensure the appropriate use.
2. Analyze psychotropic drug use data to identify trends that indicate possible abuse, and oversee nursing homes with those characteristics. 
3. Add a diagnosis code requirement to the data reports. 

What Does This Mean For You and Your Loved One? 

It is the nursing home’s responsibility to hire competent staff trained to deal with behavioral issues without the use of chemical restraints. However, data from the OIG report indicates that many nursing homes may be failing to act responsibly in this regard. 

Here are a few things to watch out for that may indicate your loved one is suffering from psychotropic drug abuse:

• You observe a decline in your loved one’s mental status, especially if it happens rapidly and without other physical symptoms.
• Your loved one is uncharacteristically sleepy, lethargic, or unresponsive during your visits. 
• The nursing home staff tells you about behavioral issues that are resolved extremely quickly, especially by staff members without full medical training.  
• You are denied access to medical records or prescription records. 
• Your loved one is being prescribed psychotropic medications without a record of seeing a physician.

If you encounter any of the scenarios above or are worried about any other suspicious circumstances, you and your loved one have the right to contact the nursing home about your concerns. You also have the right to take legal action for any abuse. 

At Solomon & Relihan, we are here to help you navigate the legal system and seek justice for any nursing home abuse experienced by your loved one. Our Phoenix law firm has been representing personal injury victims since 1974, limiting our practice to nursing home and assisted living abuse and neglect cases.

Solomon & Relihan offers decades of experience and in-depth knowledge surrounding elderly abuse and neglect. If you’re looking for a nursing home abuse lawyer in Arizona, contact us for a FREE case review and analysis today.