U.S. Nursing Homes Accused of Overprescribing Antipsychotic Medication

In order to make nursing home residents more docile and therefore easier to manage, many nursing homes are falsely diagnosing their residents with schizophrenia. The troubling nationwide trend was revealed by a New York Times investigation.

Since 2012, the year that the federal government began disclosing prescribing records of individual nursing homes out of concern over the overprescribing of antipsychotic medication, there has been a 70% increase in schizophrenia diagnoses.

In the general population, schizophrenia is a neurological condition that causes hallucinations and delusions. This condition affects approximately 1 out of every 150 people. But according to Medicare data, rates of the chronic brain disorder, which may also cause disorganized speech, disjointed thinking and lack of motivation when active, is much higher in nursing homes, with 1 in 9 residents diagnosed.

Schizophrenia, however, is rarely, if ever, accurately diagnosed at such a late stage in life. Most often, the condition manifests in one’s early 20s. It is considered relatively unheard of for someone to be diagnosed after age 40.

According to the Times investigation, administering antipsychotic drugs to elderly residents with dementia is dangerous because of drug interactions. In fact, residents with dementia who are given antipsychotic medicine are twice as likely to die from heart problems, falls, infections or other causes.

Nursing homes across the country face staffing shortages. Rather than hire more staff, many facilities have instructed their staff to administer antipsychotic drugs in order for them to physically be able to handle elderly residents.

A Yahoo News report said that federal oversight statistics showed that nearly one-third of nursing home residents in 2018 who were diagnosed with schizophrenia had no Medicare record of being treated for it.

When nursing homes had to start reporting on the number of patients prescribed antipsychotic medications in 2012, schizophrenia diagnoses were granted a de facto loophole.

Nursing homes are rated by Medicare based in part on how many antipsychotic medications each facility prescribes. If a nursing home has a high rate of prescribing antipsychotic medication for conditions other than schizophrenia, Medicare’s metrics will give the facility a lower score.

The coronavirus pandemic has only exacerbated the problem of senior-care facility staff shortages. According to a report by Wall Street Journal, the number of workers at nursing homes has declined by more than 380,000 since February 2020.