Advocacy in Action (April 2024): The Abuse of Antipsychotic Medication

Libby Hastings • Apr 08, 2024

The latest data from the Long-Term Care Community Coalition paints a troubling picture of the prevalence of antipsychotic drug use among nursing home residents nationwide. Shockingly, over 250,000 residents are being administered these dangerous drugs, often without clinical justification. Antipsychotic drugs are too frequently used as chemical restraints, particularly among individuals with dementia or dementia-related diagnoses. Instead of receiving the services they are entitled to under federal law to live comfortably, residents are being sedated, robbing them of their autonomy and quality of life. 


Antipsychotics are drugs that are used to treat symptoms of psychosissuch as delusions (for example, hearing voices), hallucinations, paranoia, or confused thoughts. They are used in the treatment of schizophrenia, severe depression and severe anxiety


In Kansas, the situation is no less alarming. Approximately 117 nursing facilities out of 300 in our state have 20% or more of their residents on antipsychotic medication. CMS Region 7 (serves Iowa, Nebraska, Missouri, and Kansas) had the highest regional rate (24.7%). This misuse of medication not only violates the rights of residents but also puts their health and well-being at risk with potentially severe consequences.


Antipsychotic drugs are associated with a host of adverse outcomes in older adults, including heart attacks, strokes, Parkinsonism, falls, and even death. It is clear that the overuse of these drugs constitutes a serious threat to the safety and dignity of nursing home residents.


Furthermore, the data from the Long-Term Care Community Coalition underscores the need for increased oversight and accountability within the long-term care industry. The fact that non-risk-adjusted data show such a high prevalence of antipsychotic drug use, coupled with a significant increase in potentially fraudulent schizophrenia diagnoses (194% increase between 2015 and 2019), is deeply concerning. 


In the "Final Report of the Kansas Senior Care Task Force to the 2023 Kansas Legislature", the Kansas Senior Care Task Force, consisting of legislative and non-legislative members, recommended leveraging technology to connect highly specialized geriatric psychiatric prescribers across the state for consultation. The task force also recommended improving upon existing standard training and education by providing targeted education for surveyors, direct care workers, providers, prescribers, long-term care providers and caregivers on the use of prescribed psychotropic medication for older adults with dementia or geriatric behavior health conditions. 


We encourage all individuals to utilize the data provided by the Long-Term Care Community Coalition. In the data spreadsheet, you can filter by state and county. 


Thank you for your ongoing support in our mission to advocate for the rights and well-being of those in long-term care.


Alarming Rate of Antipsychotic Drugging in US Nursing Homes


By Libby Hastings 10 Jul, 2024
In a recent podcast episode and article with the Kansas Reflector, Dan Goodman, Executive Director, and Libby Hastings, Communication and Public Relations Coordinator, shed light on the critical issues facing nursing facilities in Kansas. Interviewed by Tim Carpenter, they discussed the alarming findings from the Long Term Care Community Coalition's latest data regarding "problem facilities" and the federal staffing mandate from U.S. Centers for Medicare & Medicaid Services. This conversation was based on the insights shared in our July e-newsletter Advocacy in Action article and has garnered significant attention. Media outlets and local newspapers in Hays, Dodge City, Ottawa, and Wichita have picked up the Kansas Reflector story, amplifying the urgent need for reform in long-term care. At KABC, we remain steadfast in our mission to ensure quality long-term care for all Kansas residents. We invite you to read our article with Tim Carpenter and listen to the podcast episode. Your support and engagement are crucial as we continue to fight for improved care standards. We extend our heartfelt thanks to our supporters and the media for helping us share the harsh realities of nursing homes. Together, we can drive the change needed to ensure safe, dignified, and quality care for all residents in Kansas.
By Libby Hastings 05 Jul, 2024
The Long-Term Care Community Coalition (LTCCC) recently released alarming data on the state of nursing facilities across the United States, revealing that nearly one in four nursing homes (24.6%) qualify as "problem facilities." This term encompasses nursing homes that have received a one-star rating on the federal Five-Star Quality Rating System , are part of the Special Focus Facility (SFF) Program or are SFF candidates. These facilities are notable for their substandard care and persistent compliance issues.  National and Kansas-Specific Findings  The data paints a concerning picture of nursing facility care quality nationwide, and Kansas is notably worse than the national average. According to LTCCC's data, out of the 306 nursing facilities in Kansas, 25.2% are classified as "problem facilities", 59.8% of nursing facilities in Kansas are for-profit, and 75% of "problem facilities" in Kansas are for-profit.  The Five-Star Quality Rating System  The Centers for Medicare & Medicaid Services (CMS) utilizes the Five-Star Quality Rating System to aid consumers in comparing nursing homes. This system rates facilities on a scale from one to five stars, with five-star ratings indicating superior care and one-star ratings flagging the poorest quality. The effectiveness and accuracy of the CMS Five-Star Quality Rating System has been debated among long-term care advocates, residents, and their families. A star rating is composed of three parts: outcomes from the state inspection report, staffing, and quality measures.  For-Profit Facilities and Quality Concerns  The LTCCC report highlights a troubling correlation between for-profit status and lower-quality care. A federal government study , released in November 2023, concluded that for-profit nursing facilities tend to have lower quality ratings, fewer registered nurses, and more safety violations, prompting one to wonder if for-profit facilities prioritize financial returns over patient care. A February 2021 study from the National Bureau of Economic Research found that going to a facility owned by a private equity firm increased the chance that a resident would die by 10%, compared with living in another type of facility.  The Special Focus Facility Program  The SFF Program targets nursing facilities with a history of serious quality issues. Facilities are identified based on their performance over the last three standard health survey cycles and three years of complaint surveys. Points are assigned for deficiencies cited during inspections, with higher points given for more severe violations. Those facilities with the highest points become SFF candidates, marking them as requiring significant improvement. The methodology behind the SFF Program is the same as that used for health inspections within the Five-Star Quality Rating System. This rigorous approach ensures that only those facilities with the most concerning track records are selected for intensified oversight.  Implications for Consumers  The LTCCC's findings and data serve as a crucial reminder for consumers to be vigilant when selecting nursing facilities. The prevalence of "problem facilities", especially among for-profit institutions, underscores the importance of thorough research and consideration of a facility's rating and compliance history.  As always, if you would like Consumer Information Reports about any licensed long-term care facility in Kansas, feel free to call or email . There is never a charge for any of our materials.  At KABC, we will continue to advocate for increased staffing, quality care, and financial transparency within for-profit nursing facilities.
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