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When a 98 year-old woman entered a nursing home several years ago, her family dreamed that she might return to the assisted-living facility that she had called home for many years.  Unfortunately, unable to walk and suffering from dementia, she had reached a point where she needed around-the-clock care.   At the nursing home, her condition worsened, and she contracted an infection that caused diarrhea and required isolation from other residents.  After five weeks, she passed away at the nursing home.

Despite her condition, her records show that she was receiving more than 5 hours of therapy per day.  On the day that she passed away, the nursing home claims that she received more than 2 hours of therapy.  If you’re thinking that doesn’t make sense, you’re right. Here at the Jehl Law Group, we see nursing homes committing fraud like this all too often.  We have seen nursing homes bill for therapy and other services that they don’t actually provide.

Earlier this year, Kindred Healthcare Inc. and two of its subsidiaries agreed to pay the federal government $125 million to settle an ongoing fraud lawsuit. Kindred Healthcare Inc. is one of the larger nursing home chains in the country, and the government alleged that they were fraudulently billing for unnecessary therapy services. Life Care Centers of America, another large nursing home chain, is also being sued for these same practices.

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In July, the Centers for Medicare and Medicaid Services (CMS) proposed multiple rule changes applicable to nursing homes that accept funding from Medicare and Medicaid. Today we address the use of psychotropic drugs in nursing homes and the proposed rule changes to protect against their abuse. Psychotropic drugs include a broad range of drug categories, including anti-psychotic, anti-depressant, anti-anxiety, hypnotics, and opioid analgesic. These drugs have very important uses when prescribed correctly, but they also carry dangerous side effects, especially for people suffering from dementia.

Dementia patients frequently experience behavioral and psychological symptoms of dementia (BPSD) including agitation, aggression, cursing and swearing, anxiety, depression, psychosis, and wandering. As you can probably imagine or might have experienced personally, these symptoms make it more difficult to care for someone, but they can oftentimes be prevented or managed without the use of medication. However, these alternative approaches take time, effort, and patience. As a result, we often see these drugs overused in nursing home cases that we handle at Jehl Law Group.  Particularly, facilities that are under staffed or short staffed may use these drugs in excess as a way to chemically restrain residents.

These drugs carry serious side effects, especially for seniors. In particular, anti-psychotics can be dangerous if not FDA-approved “for the treatment of dementia-related psychosis.” It has been further warned by the FDA that these drugs can place dementia patients at “an increased risk of death.”[1] Not all the side effects are that serious, but most of the drugs carry risk of sedation (which is why they are used as chemical restraints), dizziness, and increased confusion. These side effects greatly increase the likelihood of falls, which oftentimes result in fractures and injuries that can be deadly to seniors. There are numerous other side effects associated with each specific psychotropic drug.