Antipsychotic Medications in the Nursing Home

The Centers for Medicare & Medicaid Services (CMS) told us last week that:

“We have made significant progress in decreasing the inappropriate use of antipsychotic medications in nursing homes, but more needs to be done,” CMS Administrator Chiquita Brooks-LaSure said. “People in nursing homes deserve safe, high-quality care, and we are redoubling our oversight efforts to make sure that facilities are not prescribing unnecessary medications.”

This seems like a great Idea. I asked my sister about this. She has been the Director of Nursing for a nursing home in California for 25 years.

I was shocked by her response. I also learned a lesson. She told me that for many nursing homes, these changes created havoc and staffing shortages. She also told me that in most cases, it did not improve the quality of life for her patients.

She went on to tell me that sadly, a large number of nursing-home patients have dementia, and when you stop giving them antipsychotic medications, instead of a docile elderly patient with dementia, you have a wide-awake patient who can start wandering around your nursing home or fighting with your staff.

Nursing homes recently received a 2.7-percent increase in payments for 2023. According to the Bureau of Labor Statistics, overall inflation for 2022 was 6.5 percent.

These cuts are forcing down the amount nursing homes are paying in salaries. Many nurses are opting to work as “travel nurses” in the home health industry, at higher rates than nursing homes can pay, leading to staff shortages. 


Timothy Powell, CPA

Timothy Powell is a nationally recognized expert on regulatory matters, including the False Claims Act, Zone Program Integrity Contractor (ZPIC) audits, and U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) compliance. He is a member of the RACmonitor editorial board and a national correspondent for Monitor Mondays.

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