Report Reveals Impact of CMS Initiative Aimed at Reducing Use of Antipsychotic Medications

The Centers for Medicare and Medicaid Services (CMS) launched the initiative Partnership to Improve Dementia Care in Nursing Homes to lower the use of antipsychotic medication in nursing home facilities. The aim of this initiative was to reduce the inappropriate use of antipsychotic drugs by 15%. However, this goal was not met, and as of 2013, the rate of antipsychotic drug use for long-stay residents was reported to be about 21%, which was approximately a 9% reduction. This meant that more than 1-in-5 residents, or about 300,000 individuals, are still being administered antipsychotic medications.

The Center for Medicare Advocacy recently issued a report analyzing antipsychotic medication use in nursing home facilities. One aspect of the report delved into the perspectives of state surveyors and their process of citing facilities for antipsychotic drug deficiencies. Specifically, the report revealed whether or not the surveyors found any changes in the practices of nursing home facilities after CMS launched its antipsychotic medication initiative.


Some surveyors reported positive changes within facilities due to the initiative. For instance, reports stated that facilities were more responsive and aware of antipsychotic medication issues. However, some described disturbing and negative results of the initiative, claiming instances of facilities falsifying records, or switching residents to other medications that were just as inappropriate. Furthermore, surveyors found occurrences in which physicians created false diagnoses for residents in order to justify the administration of antipsychotic medications. Other concerns were exposed, including the nursing home industry’s failure to comply with federal regulations until they were actually held liable and accountable. It was found that the primary concern of surveyors was the issue of understaffing. Surveyors reported alarmed reactions as to how understaffed nursing home facilities were at night, stating understaffing to be the root of many problems within facilities. One surveyor stated there wasn’t enough trained staff to address residents with advanced dementia. Another stated their unease at how little staff members were present at the facilities during night shifts. Furthermore, another surveyor stated there was not enough staff to address the bare minimal needs of residents, and that the nurse to resident ratio was far too low considering the patient acuity levels.

Under Health and Safety Code section 1599.1(a), understaffing constitutes a violation of the Patient’s Bill of Rights, which requires every skilled nursing facility to employ an adequate number of qualified personnel in order to carry out the functions of the facility. In order to cut costs, many nursing home facilities often hire more nursing assistances rather than licensed nurses. However, adequate staffing not only constitutes the number of staff members who provide care within a facility, but also constitutes the quality of care that is provided. As such, staff members who are not qualified or who are inexperienced in providing the level of care patients require also constitutes understaffing.

At the Law Offices of Ben Yeroushalmi, we believe all patients and nursing home residents are entitled to high quality health care. If you believe the facility in which your elderly loved one is residing is failing to meet the standard of care due to understaffing, we encourage you to call us at (888) 606-3453 for a free consultation today. We are located in both Northern and Southern California and serve cities throughout the state. Help us fight against elder abuse and neglect that arises as a result of understaffing. With years of experience in elder abuse litigation, we specialize in neglect cases and can help you with yours.