Medicare is using its five-star rating system of nursing homes to curb antipsychotic usage. Antipsychotics are FDA-approved medication for schizophrenia and bipolar disorder, but advocates say antipsychotics are being overused as a way to chemically restrain agitated or aggressive residents.
Despite the new system, America Tonight found more than 40 nursing homes with five-star ratings that use antipsychotics at more than twice the national average.
Tony Chicotel with California Advocates for Nursing Home Reform said antipsychotic use only has a small impact on a nursing home’s star rating.
“The five-star rating system is sort of enforcement lite,” he said. “It’s not telling facilities, ‘If your rate is high, you’ve done something wrong. If you’re drugging people without the necessary clinical indications, you’ve done something wrong, and you’re going to have to pay for it.’”
Chicotel said too many nursing homes continue to see antipsychotics as a quick solution for residents’ difficult behavior. “It’s easy to call the physician and get a prescription and give it to them and suddenly they’re quiet,” he said.
Since 2012, there have been 100,000 fewer nursing home residents residents on antipsychotics. “That’s amazing, at one level,” Chicotel said. “On the other hand, if you’re looking at this issue as something that’s intolerable — one person on antipsychotics who doesn’t need it should not be tolerated — then we have a long way to go… You still have approximately 300,000 nursing home residents on antipsychotics, and that’s a number that’s embarrassing. That’s a national embarrassment.”