Fewer Antipsychotic Drugs, More Nurses Will Improve Care, Save Money in Nursing Homes
Senate Special Committee on Aging hearing focuses on long-term care for senior citizens; The Center for Medicare Advocacy
April 23, 2012 -
The Center for Medicare Advocacy issued a statement last week saying that huge savings in nursing facility costs, and advances in resident
care, could be achieved if facilities eliminated the inappropriate use of antipsychotic drugs and provided sufficient staff to meet resident
"Hundreds of thousands of residents receive antipsychotic drugs each day in nursing homes across the country, even though
these drugs are inappropriate and life-threatening for the vast majority of residents to whom they are given." said Toby S. Edelman, Senior
Policy Attorney with the Center's Washington, DC office.
The Future of Long-Term
Care: Saving Money by Serving Seniors
Hearing by U.S. Senate
Special Committee on Aging
Held April 18, 2012
Of the $2.1 trillion spent in 2009 on all U.S.
personal health care services, $294.4 billion, or 14.1%, was spent on formal, or paid, long-term care. The bulk of these costs 71%
or $209 billion were paid for by taxpayers, largely through Medicaid ($126.8 billion) and Medicare ($62.6 billion.) And, patients
and their families paid $52.4 billion in out-of-pocket expenses.
The hearing will focus on the long-term care
system and opportunities for improving the quality of care while at the same time achieving significant cost savings. The hearing will
also highlight the need, risks and costs of long-term care insurance, especially for working Americans.
Click here to video of hearing
● Statement by Committee Chairman
Senator Herb Kohl (D-WI),
Click name for Panel Testimony
John O'Brien, Director of Healthcare and Insurance, Office of Personnel Management,
Loren Colman, Assistant Commissioner, Minnesota Department of Human Service, St. Paul,
Judy Feder, Professor of Public Policy and Former Dean, Georgetown Public Policy
Institute, Georgetown University, Washington, DC
Bruce Chernof, President and CEO, SCAN Foundation, Long Beach, CA
Douglas Holtz-Eakin, President, American Action Forum, Washington, DC
The Center's statement was to add to comments at the Senate Special Committee on Aging hearing on April 18, 2012 The Future of
Long-Term Care: Saving Money by Serving Seniors. It was to call attention to the connection between high quality of care and lower costs to the
Medicare and Medicaid programs. The Center also issued a commendation to the committee for the hearing.
In 2005 and 2008, the Food and Drug Administration issued Black Box warnings about atypical and conventional
antipsychotic drugs, respectively, advising that these drugs can cause the death of older people who have dementia.
Antipsychotic drugs are
also included on the Beers List of drugs that are inappropriate for most older people. As the Office of Inspector General reported in May
2011, the Medicare program pays hundreds of millions of dollars for these drugs annually.
Staffing is a second critical issue. "More than a decade ago, the federal Medicare agency reported that more than 90% of
nursing facilities did not have sufficient staff to prevent avoidable harm to nursing home residents or to meet their residents' needs. It is
a national disgrace that such gross understaffing continues, when federal law since 1990 has required, and paid, facilities to have sufficient
numbers of staff," said Ms. Edelman.
What are the consequences of insufficient numbers of professional nurses and paraprofessional nursing staff? Among other
poor outcomes of inadequate staffing, with large financial consequences,
● Residents are sent to the emergency room and are otherwise hospitalized when there are not enough registered nurses,
and virtually no doctors, to provide the high level of care that today's nursing home residents need; and
● Residents develop avoidable pressure sores that cause pain and cost hundreds of millions of dollars to treat.
TCMA's statement for the hearing is available by
clicking this link.
TCMA also referenced the following sources as backup information.
● Management of Behavioral and Psychological Symptoms in People with Dementia Living in Care Homes: A UK
Perspective, by Clive Ballard:
● Lucette Lagnado, Prescription Abuse Seen In U.S. Nursing Homes; Powerful Antipsychotics Used to Subdue Elderly;
Huge Medicaid Expense, Wall Street Journal (Dec. 4, 2007),
http://www.medicareadvocacy.org/wp-content/uploads/2012/04/Antipsychotics-Wall-Street-Journal-Rx-and-nhs-12.04.07.pdf (article led
Senator Grassley to request the OIG report, which came out in May 2011)
● Office of Inspector General, Department of Health and Human Services, Medicare Atypical Antipsychotic Drug Claims
for Elderly Nursing Home Residents, OEI-07-08-00150 (May 2011),
The Center for Medicare Advocacy, Inc., established in 1986, is a national nonprofit, nonpartisan organization that
provides education, advocacy and legal assistance to help older people and people with disabilities obtain fair access to Medicare and
necessary health care. The Center is headquartered in Connecticut with offices in Washington, DC and throughout the country.
Nursing Home Abuse,
Medical Malpractice -
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