WASHINGTON, DC - Today, House Ways and Means Committee Democratic staff released a new report exposing the longstanding misuse of antipsychotics and the minimal enforcement in preventing patient harm in nursing homes nationwide. “Under-Enforced and Over-Prescribed: The Antipsychotic Drug Epidemic Ravaging America’s Nursing Homes" shows how many facilities resort to the use of these potentially dangerous drugs in lieu of proper staffing and underscores the urgent need for robust oversight of the nursing home industry and improved deployment of existing tools to prevent such harm in the first place. The Trump Administration has under-utilized the oversight tools at its disposal despite the Food and Drug Administration issuing a black box warning against the use of antipsychotics for elderly patients with dementia. Just as the COVID-19 pandemic has laid bare harsh realities in nursing home care, this abuse is another unfortunate example of the patient harm, inadequate oversight, and insufficient staffing plaguing residents of skilled nursing facilities (SNFs).
“The state of affairs at our nation’s nursing homes is absolutely heartbreaking-from COVID hotspots to the over-prescription of antipsychotics detailed in today’s report, the residents of these facilities and their families deserve better," Chairman Neal said. “This pattern of overprescribing such dangerous drugs is unacceptable, particularly coupled with the Trump Administration’s campaign to loosen regulations designed to protect patients from harm. It is critical that the administration immediately addresses this misuse to better protect vulnerable residents and give their families peace of mind."
Key Findings from “Under-Enforced and Over-Prescribed: The Antipsychotic Drug Epidemic Ravaging America’s Nursing Homes":
* Approximately 20 percent of all skilled nursing facility residents in the United States - about 298,650 people every week - received some form of antipsychotic medication in the fourth quarter of 2019, while only about two percent had qualifying conditions for such drugs.
* Citations for antipsychotic misuse in SNFs increased by 200 percent between 2015 and 2017 but declined by 22 percent from 2017 to 2018 as the Trump Administration rolled back Obama-era protections.
* Ten percent of citations associated with classifications of “Actual Harm" or “Immediate Jeopardy" to a resident’s health or safety resulted in no fine from 2017-2018.
Skilled Nursing Facility Antipsychotic Citations, 2018
Read the summary of the report HERE.
Related Ways and Means Committee Work
The Ways and Means Committee held a hearing titled, “Caring for Aging Americans," last November, and in May, the Health Subcommittee held another hearing that looked exclusively at the COVID-19 crisis in nursing homes.
Over the years, Chairman Neal repeatedly expressed his concerns with the overuse of antipsychotics and nursing home care in letters to CMS Administrator Seema Verma, HUD Secretary Ben Carson, and other stakeholders:
* Neal Letter to Seema Verma on Overuse of Antipsychotics in Nursing homes (July 25, 2018)
* Neal Letter to Seema Verma on Continued Concern with Overuse of Antipsychotics in Nursing Homes (Jan 22, 2019)
* Neal Letter to Ben Carson on Inspections for Nursing Facilities that have Section 232 REAC Loan Guarantees (May 22, 2019)
* Neal Letter to DOJ Antoinette Bacon on Concern of OIG Report Results (Aug 17, 2019)
* Neal Letter to Seema Verma on Concern over OIG Report Results (Aug 17, 2019)
* Neal Letter to LTC Pharmacists on Antipsychotics Overuse (Aug 28, 2019)
The Committee also sent a series of letters urging the Trump Administration to offer additional assistance and conduct more oversight of nursing homes as they struggle to battle COVID-19 outbreaks:
* Neal-DelBene letter on COVID-19 (March 3, 2020)
* Neal-Wyden letter on COVID-19 (March 5, 2020)
* Neal Letter on the Rampant Spread of COVID-19 Across Nursing Homes as a Human Rights Issue (April 17, 2020)
* Neal Letter to CMS on Allocation of Provider funds to Skilled Nursing Facilities (May 8, 2020)
* Neal-Pallone Letter to CMS to Stop Nursing Facilities from Seizing Residents’ Economic Impact Payments (June 8, 2020)
* Neal letter to CMS to Ramp Up Oversight of Nursing Homes as Pandemic Continues to Devastate Long-Term Care Facilities (July 10, 2020)
