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New York is increasing its focus on antipsychotic drug use in nursing homes, training inspectors to spot signs of medication abuse.

Medicaid spends more money on antipsychotic drugs than any other medication – including – antibiotics and high blood pressure medication. The reason – nursing homes across the United States are giving antipsychotic drugs to quiet patients who suffer symptoms of dementia and Alzheimer’s disease.

About 30% of the total nursing home population is receiving antipsychotic drugs, while nearly 21% of the patients being given these drugs do not suffer psychosis, according to the Centers for Medicare and Medicaid Services (CMS).

That is what happened to a woman listed in New York state health department inspection records as Resident #18. The 84-year-old Alzheimer’s patient, who lives at the Orchard Manor nursing home in Medina, N.Y., likes to wander and roll her wheelchair around her unit, according to a report filed earlier this year, and sometimes she nervously taps her foot.

To address her behavior, which was considered disruptive, Resident #18 was given a powerful antipsychotic drug called Seroquel, a drug approved for schizophrenia and bipolar disorder. Resident #18 is not psychotic and Seroquel — like other atypical antipsychotics — carries a “black box” warning that elderly dementia patients using it face a higher risk of death.

Federal and state regulators are citing nursing homes for using antipsychotic drugs in ways that violate federal rules.

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