Report builds on concerns raised by Grassley, Wyden
November 24, 2022 - WASHINGTON – Roughly 80 percent of nursing home residents on Medicare received psychotropic drugs between 2011 and 2019, according to a Health and Human 
Services watchdog report. The report followed concerns raised by then-Senate Finance Committee chairmen Chuck Grassley (R-Iowa) and then-Ranking Member Ron Wyden (D-Ore.).
Senator Chuck Grassley (R-Iowa)
“Nursing home residents deserve to be treated with dignity, and their loved ones ought to have the confidence that nursing homes are prescribing medicines appropriately. Unfortunately this Inspector General report confirms many of our fears that serious medications are being administered without appropriate diagnoses or oversight,” Grassley said.
“I am very disturbed by reports of the high and potentially improper use of psychotropic drugs in nursing homes. This report makes it clear that more needs to be done to protect nursing home residents, and I will continue working to make that a reality,” Wyden said.
Specifically, the report found that “from 2011 through 2019 about 80 percent of Medicare’s long-stay nursing home residents were prescribed a psychotropic drug . . . [and], while CMS focused its efforts on reducing the use of psychotropic drugs—antipsychotics—the use of another category of drug—anticonvulsants—increased.” This resulted in the overall use of psychotropic drugs to remain constant during this time period.
HHS OIG also found that nursing homes with certain characteristics were associated with higher use of psychotropic drugs. For example, nursing homes with lower ratios of registered nurse staff and those with a higher percentage of residents with low-income subsidies were associated with higher use of these dangerous drugs. HHS OIG expressed its concerns that nursing homes could misreport residents as having schizophrenia, since CMS’s long-stay quality measure that tracks antipsychotic use in nursing homes excludes residents with this diagnosis.
Read the full IG report here.
Senator Grassley first called on HHS OIG to investigate the use of prescribing antipsychotics and other drugs for elderly and nursing home residents over a decade ago. In response to Senator Grassley’s oversight push, in 2011, HHS OIG found that 14 percent of our nation’s 2.1 million nursing home residents had Medicare claims for atypical antipsychotic drugs in a six-month period, these drugs often were prescribed to manage behavioral symptoms of patients with dementia, and at least half of such claims were erroneous, amounting to $116 million in inappropriate Medicare reimbursement claims.
Source: Senator Chuck Grassley
