Government is lax in issuing serious citations for antipsychotic overuse, NPR claims

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Only 2% of nursing home deficiencies for inappropriate medication lead to a fine or harsher penalty, suggesting that the government is not doing enough to reduce antipsychotic drugs, NPR reporters argued in a story that aired Tuesday.

While nursing homes have reduced antipsychotic prescribing to residents with dementia by more than 15% since 2012, some states are lagging far behind, reporters Ina Jaffe and Robert Benincasa pointed out. Texas currently is in last place, but the government is not imposing more fines or severe penalties on facilities in the Lone Star State than in other places, they noted.

The approach to antipsychotic reduction has been a partnership between various stakeholders, including the states, federal agencies such as the Centers for Medicare & Medicaid Services and long-term care provider associations. But the results in Texas suggest “collaboration doesn't always work,” the reporters proposed.

American Health Care Association/National Center for Assisted Living President and CEO Mark Parkinson defended the current strategy. "I think that the data will continue to show that collaboration works, and that conflict and fighting don't work,” he told NPR.

Deficiencies don't often rise to the most severe level for inappropriate medication because “near misses” are common, said CMS Chief Medical Officer and Deputy Administrator for Innovation and Quality Patrick Conway, M.D. In these instances, an unnecessary medication is dispensed but does not cause permanent harm. Regulators view these situations as a “learning opportunity” rather than a reason for severe sanctions, he explained.

In fact, the government is shirking its duty to protect consumers, argued Toby Edelman, senior policy attorney with the Center for Medicare Advocacy.