In 2012, the federal Centers for Medicare and Medicaid Services (CMS) launched the National Partnership to Improve Dementia Care to reduce the use of dangerous antipsychotic (AP) drugs in nursing homes. This report, “A Decade of Drugging,” examines how dementia care has – and hasn’t – changed since the launch of the Partnership and finds that a once-promising campaign has sputtered and fallen short of its goals to curb AP drug use.

This page contains a PDF of the report along with supplementary materials including comprehensive AP drugging datasets, an interactive Tableau dashboard illustrating state and national AP drugging trends, a list of commonly prescribed AP drugs (generic and brand names), and dementia care resources to support resident-centered advocacy.

A Decade of Drugging

Sedation of nursing home residents with dangerous antipsychotic drugs persists despite federal partnership.

Antipsychotic Drugs by the Numbers

  • 250,000: Nursing home residents receiving dangerous APs each week.

  • 1.1 million: Residents that could have been spared from dangerous AP drugs had CMS set and achieved an annual reduction goal of 20%.

  • 80%: The rate of residents using psychotropic drugs (which has remained constant since 2011).

  • 1 in 3: Residents reported in the MDS as having schizophrenia without evidence of the diagnosis in their Medicare claims history..

Antipsychotic Drugging & Schizophrenia Rates (2012-2021)

Year (Q2) Risk-Adjusted Non-Risk-Adjusted Percent Excluded Schizophrenia Rate
2012 23.2% 25.6% 9.4% 6.6%
2013 21.1% 24.0% 12.0% 6.9%
2014 19.4% 22.6% 14.0% 7.1%
2015 18.0% 21.6% 16.6% 7.4%
2016 16.3% 20.7% 21.1% 8.0%
2017 15.5% 20.2% 23.2% 8.5%
2018 14.6% 20.0% 26.9% 9.1%
2019 14.3% 20.0% 28.6% 9.5%
2020 14.1% 20.8% 32.2% 10.6%
2021 14.4% 21.4% 32.6% 11.1%

Sources: MDS 3.0 Frequency Reports & CMS National Partnership

Notes

CMS’s risk-adjusted AP drugging metric excludes residents with a diagnosis of schizophrenia, Huntington’s Disease, or Tourette’s Syndrome. Researchers have found that the modest declines in AP drugging rates stem from significant increases in false schizophrenia diagnoses. Since the start of the Partnership, the share of residents receiving APs but excluded by the risk-adjusted metric has nearly tripled, largely due to increases in false schizophrenia diagnoses.