The Department of Health and Human Services Office of Inspector General published a report in March 2026 (https://oig.hhs.gov/documents/evaluation/11547/OEI-02-23-00200.pdf) of a review that highlighted the inappropriate use of antipsychotic drugs in nursing homes. Of course, nursing home abuse is a significant issue in the United States and results in a significant number of personal injury lawsuits each year.
It has long been a concern that the sedative effect of antipsychotics may be being used by nursing home staff to control residents’ behavior. This is especially concerning because antipsychotic drugs are not approved by the FDA to treat patients with dementia. In fact, the FDA has imposed a black box warning, the strongest warning, on the use of antipsychotic drugs by elderly patients with dementia. Accordingly, the use of these medications is very often a sign of negligent care and treatment by the nursing home staff. The Centers for Medicare & Medicaid Services (CMS) has put in place restrictions on the use of drugs in nursing homes that participate in Medicare and Medicaid, including that residents must be “free from chemical restraints imposed for the purposes of staff convenience.” Additionally, nursing homes must have a documented clinical rational for administering a medication based on the resident’s condition and is consistent with the manufacturer’s recommendations and/or clinical practice guidelines.
The OIG’s review found that nursing homes gave antipsychotic drugs to residents with dementia to manage their behavior for the benefit of staff, even when this behavior posed no risk to themselves or others. Medical directors failed to prevent this inappropriate use of such drugs with one nursing home psychiatrist admitting that “[the] medications are more [for the] benefit of [the] staff.” The review also found that nursing home pharmacists failed to identify medical concerns and did not recommend dosage reductions despite CMS requirements for monthly review of residents’ medication regimens. The failure of a pharmacist to identify these issues may also be found to be negligent conduct. Further, the review found that inadequate policies and procedures undermined safeguards that were meant to protect residents from inappropriate use of antipsychotic drugs.


