Vulnerable elderly residents face serious risks and premature death from antipsychotics, as nursing homes and their prescribers evade meaningful accountability.
LOS ANGELES, CA, April 20, 2026 /24-7PressRelease/ — The Citizens Commission on Human Rights International (CCHR), a 57-year mental health industry watchdog, warns that vulnerable elderly residents in U.S. nursing homes continue to face serious risks of premature death from antipsychotics. Facilities and their prescribers evade meaningful accountability despite decades of federal investigations, congressional promises, and repeated calls for reform. Penalties remain far too weak to deter the abuse.
The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently issued two reports examining psychotropic drugging in nursing homes. In a review of 40 Centers for Medicare and Medicaid Services (CMS) inspections, the OIG found that facilities routinely administered antipsychotics—drugs not Food and Drug Administration (FDA)-approved for dementia and linked to increased mortality—to control resident behavior, while frequently failing to implement required safeguards.[1]
“The inappropriate use of antipsychotic drugs in nursing homes has been a longstanding concern for Congress and others,” the OIG stated. The reports also exposed a deliberate tactic: some nursing homes misdiagnose residents with “schizophrenia” to bypass accountability and artificially improve public quality ratings. The OIG recommended that CMS strengthen oversight, closely monitor schizophrenia diagnosis rates, target high-risk facilities, and ensure residents and families receive clear information about antipsychotic use.
CCHR’s international president, Jan Eastgate, responded: “We’ve heard it all before. This abuse has been reported for decades—especially promises of increased oversight—yet doctors continue to deliberately misdiagnose residents and ply the elderly with debilitating antipsychotics. What makes this particularly outrageous is that despite repeated investigations and warnings, the penalties are so weak they fail to deter anyone.”
Current penalties—capped at $1,000–$5,000 for false certifications—are woefully inadequate. HHS OIG may impose greater sanctions, yet enforcement has historically been lax.
In 2011, OIG Inspector General Daniel Levinson declared: “Government, taxpayers, nursing home residents, as well as their families and caregivers, should be outraged—and seek solutions.”[2] Fifteen years later, that outrage has yet to produce lasting change. In 2023, although HHS identified serious problems with inappropriate antipsychotic use and inaccurate schizophrenia diagnoses, the agency stopped short of meaningful action. It did not impose substantial financial penalties.[3]
Antipsychotics carry well-documented dangers for the elderly. In 2005, the Food and Drug Administration (FDA) issued a black-box warning for their use in dementia patients due to elevated death risks.[4] In 2007, FDA senior drug safety official Dr. David Graham warned that at least 15,000 nursing home residents die annually from these drugs.[5] A 2024 American Association of Retired Persons report found that in people with dementia aged 50 and older, antipsychotics more than doubled the risk of pneumonia—the leading cause of death in this population—while also increasing risks of stroke, acute kidney injury, blood clots, bone fractures, heart attack, and heart failure.[6] A Journal of Clinical Psychiatry study further noted that side effects are particularly problematic in elderly patients due to age-related changes.[7]
The problem dates back decades:
1987: Congress passed the Omnibus Reconciliation Act, including the Nursing Home Reform Act, intended to curb chemical restraints—yet the practice shifted to medication-based “chemical restraints.”[8]
2007: Sen. Chuck Grassley called for an OIG review of antipsychotic use and marketing in nursing homes.[9]
2011: The OIG reported that 88% of antipsychotics were prescribed off-label to elderly dementia patients despite FDA warnings. The Lancet revealed that more than half of Medicare-paid antipsychotics for those over 65 were for unapproved uses.
2012–2015: CMS’s National Partnership to Improve Dementia Care reduced prescribing somewhat, but “schizophrenia” diagnoses rose sharply, undermining progress.[10]
2019–2020: Roughly 20% of skilled nursing facility residents—about 298,650 people weekly—received antipsychotics. A House Ways and Means report described the crisis as “one of patient harm, inadequate oversight, and insufficient staffing.”[11]
2025–2026: CMS continued to acknowledge the dangers and has updated its measuring system, yet inappropriate use persists.[12]
“This continued drugging despite repeated investigations and promised reforms is outrageous. Accountability has been negligent,” Eastgate concluded. “Substantial civil, financial, and criminal penalties must be imposed, starting with the prescribers who diagnose and prescribe antipsychotics, followed by the nursing homes complicit in the abuse. Our seniors deserve compassion and safety, not sedation and premature death.”
CCHR urges Congress, CMS, and state authorities to enact immediate, enforceable protections—including strong penalties on prescribers and facilities—and to prioritize non-drug alternatives for behavioral care in nursing homes.
Sources:
[1] Nursing Homes’ Inappropriate Use of Antipsychotic Drugs Poses a Risk to Residents, OIG, 16 Mar. 2026, oig.hhs.gov/reports/all/2026/nursing-homes-inappropriate-use-of-antipsychotic-drugs-poses-a-risk-to-residents/
[2] “Overmedication of Nursing Home Patients Troubling,” OIG, 1 June 2011
[3] “Nursing Homes Under Investigation for Abuse of Antipsychotics,” Newsmax.com, 18 Jan. 2023
[4] Jeanne Lenzer, “FDA warns about using antipsychotic drugs for dementia,” BMJ, 23 Apr. 2005,
[5] Testimony by Dr. David Graham, House Hearing, 110th Congress – The Adequacy of FDA to Assure the Safety of the Nation’s Drug Supply General, 13 Feb. 2007, p. 66
[6] “Antipsychotics Pose New Risks for People With Dementia,” AARP, 24 Apr. 2024, Updated 27 Jan. 2026
[7] P S Masand, “Side effects of antipsychotics in the elderly “J Clin Psychiatry, 2000
[8] “Under-Enforced and Over-Prescribed: The Antipsychotic Drug Epidemic Ravaging America’s Nursing Homes.” Report of the Committee on Ways and Means Majority U.S. House of Representatives, July 2020, p. 9
[9] “Grassley seeks thorough review of nursing home use of anti-psychotic drugs,” 6 Dec. 2007
[10] “Long-Term Trends of Psychotropic Drug Use in Nursing Homes,” Health and Human Services Office of the Inspector General, 11 Nov. 2022
[11] “Under-Enforced and Over-Prescribed: The Antipsychotic Drug Epidemic Ravaging America’s Nursing Homes.” Report of the Committee on Ways and Means Majority U.S. House of Representatives, July 2020, pp. 6, 16
[12] “State Survey Agency Directors,” CMS Center for Clinical Standards and Quality, 18 June 2025, p. 3
CCHR is a nonprofit mental health watchdog, established by the Church of Scientology and Professor of Psychiatry, Thomas Szasz, M.D., dedicated to eradicating abuses committed under the guise of mental health care. Since 1969, CCHR has helped secure hundreds of laws protecting individuals from coercive psychiatric practices.
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