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Why Did a Nursing Home Put My Loved One on Antipsychotics?

We have discussed in previous posts the dangers of chemical restraints. Unscrupulous nursing home facilities will use medications to help make their residents more compliant. This can result in an easier-to-manage resident population and a reduced staffing need. In the worst of circumstances, this allows executives to reap the financial benefit at the expense of their residents.

The issue of over-medication was discussed in more detail here, but a new problem discovered by a recent New York Times investigation calls for even more concern.

What is this new problem?

In addition to over-medicating residents, some facilities are using loopholes to avoid reporting the presence of the medication to the public. Laws are in place that ban the use of drugs to serve the interest of the nursing home, not the patient and in 2012 the federal government began requiring nursing homes to report to Medicare how many residents were getting antipsychotic drugs.

This report would then be part of the agency’s “quality of resident care” score. The more residents are on antipsychotic drugs, the lower the score. In an effort to make sure facilities were not deterred from accepting certain residents, exceptions were allowed. A facility’s use of the medication for residents with diagnosed schizophrenia, for example, was not part of the calculation.

According to the New York Times investigation, some facilities then encouraged physicians to provide a schizophrenia diagnosis for their residents who suffer from dementia, thus allowing the use of the antipsychotic medication for an easier to manage resident. The move was not without risk. The medication has some serious side effects and can lead to harm when used unnecessarily.

Good facilities don’t have this problem, right?

This is a problem that plagues highly rated facilities as well as the low. A report by the inspector general of the Department of Health and Human Services (HHS) found that 20% of 52 inspected facilities had an unsupported diagnosis. Over half of those facilities had a four-star rating or more out of five.

Unfortunately, one example given in the New York Times report was from here in Miami. The Hialeah Shores Nursing and Rehabilitation Center is a 106-bed facility with a five-star rating. Official statistics state the facility uses antipsychotic medications for about 10% of its long-term residents in 2018. In reality, over 30% were on antipsychotics.

Antipsychotics are just one medication used to help increase compliance among residents. Although not a treatment for dementia, some nursing homes have also chosen to start the use of Depakote, a medication used for epilepsy and bipolar disorder, to help manage their dementia patients.

This is an example of nursing home facilities may attempt to change their ways to reach the same goal — maximize profits. There are good facilities out there, but those who believe their loved ones are victims of poor care within a questionable facility can take action to hold that facility accountable for their wrongdoing.

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