The House Ways & Means Committee has released a report examining the continued misuse of antipsychotic drugs in America’s nursing homes. While the report is a much needed analysis of the awful state of chemical restraint use in nursing homes, the report is also very frustrating as it comes forty-five years after a seminal Congressional hearing talking about the same exact problems.

The new report highlights that, despite a highly-touted eight year old CMS campaign to reduce antipsychotics in nursing homes, the rate of residents given antipsychotics remains stubbornly high at 20%. CMS continues to use a disingenuous measure for “appropriate” use of antipsychotics that understates the actual rate of misuse, especially now that it is gamed by nursing homes everywhere.

Much of the report analyzes the enforcement of laws prohibiting misuse of antipsychotics and finds some very disturbing trends. Enforcement is down, with fewer citations issued against facilities for misusing antipsychotics and smaller fines when citations are issued. Most alarming, a miniscule 0.02% of cited antipsychotic misuse was found by government investigators to have committed any harm to the victims. This leads to a slap-on-the-wrist enforcement problem that encourages continued misuse. The 0.02% rate powerfully demonstrates that the enforcement system is broken when it comes to antipsychotic misuse.

California does not fare well in the report. Citations for antipsychotic misuse in California nursing homes decreased 36% from 2016 to 2018 despite the fact that antipsychotic usage rates increased from 19.3% to 19.6%.

This new report is a good reminder that chemically restraining residents remains business as usual in many nursing homes and that our laws prohibiting chemical restraints continue to be largely ignored. Until enforcement of the laws is prioritized, residents will continue to tragically suffer in harmful drug stupors.