New Ways and Means Report Finds Nursing Homes Abuse Antipsychotics at Alarmingly High Rates While Trump Administration Conducts Little to No Oversight

Jul 27, 2020
Press Release
Committee Democrats released “Under-Enforced and Over-Prescribed: The Antipsychotic Drug Epidemic Ravaging America’s Nursing Homes” today
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.

The full report is available 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:
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: