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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 offers ideas

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 needs.

"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, Washington, DC

   ● Loren Colman, Assistant Commissioner, Minnesota Department of Human Service, St. Paul, MN

   ● 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:


Related Archived Stories


Study Recommends Ways to Evaluate End of Life Care in Nursing Homes

Discussion begins about need to create end of life quality measures to inform consumers and provide nursing homes with incentive to improve care

April 16, 2012

Read more Elder Care & Caregivers News


   ● 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), (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 -
• Experienced Legal Help

 Beth Janicek, Board Certified Personal Injury Attorney Janicek Law attorneys are working every day to help senior citizens and others harmed by failure of care in nursing homes and the healthcare system.

If you or a loved one have suffered due to the neglect or inadequate care of others, call us today. We offer the skill and knowledge gained in more than twenty years of success.

Free Consultation - Call toll free 1-877-795-3425 or Email

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