Pennsylvania Nursing Home Abuse Attorney Blog

Our Pennsylvania nursing home negligence lawyers were disturbed to see a recent report suggesting some nursing homes have intentionally over-medicated their patients. The New York Times reported Jan. 15 that federal regulators have sued Johnson & Johnson for paying illegal kickbacks to a nursing home pharmaceutical distributor named Omnicare. The complaint in Boston federal court said Johnson & Johnson paid Omnicare to buy its products. Those products included prescription drugs like the powerful antipsychotic Risperdal, which is frequently used off-label to control behavior in patients with dementia. The Justice Department accused Johnson & Johnson of committing Medicaid fraud by inflating the number of prescriptions it paid.

Omnicare is a "middleman" that manages insurance issues, processes payments and distributes medications. The government alleges that it took illegal payments from Johnson & Johnson from 1999 to 2004. Among other things, the lawsuit says the drug maker paid for information previously distributed for free, and paid rebates every quarter based on Omnicare's success at switching patients to its drugs from competitors' drugs. These rebates are legal, but only if Medicaid gets the same discount as other large purchasers. The lawsuit says Johnson & Johnson tried to disguise its rebates to Omnicare in quarterly reports to the government.

As Philadelphia nursing home abuse attorneys, we wonder how many other companies may be guilty of similar behavior. Kickbacks are particularly dangerous in nursing homes because they encourage nursing homes to over-prescribe medicines. Some of these medicines may be appropriate, but they can also carry serious side effects. In fact, we wrote here last week about problems with the atypical antipsychotic Risperdal, which carries an FDA warning that it may increase the risk of death in elderly patients with dementia.

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Families looking for a safe, loving and dignified home for their loved ones should turn to a recent issue of U.S. News & World Report magazine. As Philadelphia nursing home negligence attorneys, we're glad to say that the magazine has created a resource for families similar to its yearly college rankings. The magazine offers starred rankings of several aspects of each home, along with indicators of homes with problems and information on their ownership, size and whether they take Medicare or Medicaid. It has also published a four-step guide to choosing a nursing home.

The "how to choose" guide is actually four separate guides, each focusing on a separate part of the process. The first guide asks readers to decide whether a home is truly necessary, the second shows how to build a short list, and the third explains what to look for at the all-important on-site visit. The fourth and final article explains how to follow up to ensure that your choice is working out. The rankings themselves rely on a Medicare tool called Nursing Home Compare, but expand that tool's search capability to include multiple criteria, such as ranking, location and religious affiliation. Information is updated every quarter.

As Pennsylvania nursing home neglect lawyers, we think this is a great tool for families making this important choice. Nursing home choice matters greatly, because the nursing home is your loved one's permanent, long-term home. A bad nursing home can lead to unhappiness, but also serious health problems from neglect or abuse, or even death.

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As Philadelphia nursing home neglect lawyers, we were very interested in a new study published in the Jan. 11 issue of the Archives of Internal Medicine. Researchers from the University of Massachusetts at Worcester found that in 2007, a disproportionately large proportion of nursing home patients received a drug from a class of drugs known as atypical antipsychotics. These drugs are indicated for mental illnesses like schizophrenia, but have several side effects serious enough that their use is now heavily restricted by the FDA. In particular, a 2005 safety labeling change warned that atypical antipsychotics may raise the risk of death in older people with dementia.

No drug is currently approved for controlling difficult behavior in patients with dementia, but atypical antipsychotics are widely used off-label for this purpose. This is despite the 2005 safety warning and the increased risk of stroke, diabetes, hyperglycemia and other side effects. Nonetheless, the study found that about a third of all nursing home patients in 2007 received the drugs. And one third of those patients had no diagnosis of mental illness or dementia. The scientists also found that patients were more likely to receive atypical antipsychotics after entering a nursing home that already had high prescribing rates. This may indicate a problem with "organizational culture," the authors wrote, and more studies should examine whether the practice has negative health consequences.

This is disturbing news, because it suggests that some nursing homes may be using dangerous, powerful drugs unnecessarily. The risks of atypical antipsychotics are so serious that another recent study found a 19% drop in prescriptions after the 2005 safety warning. Nursing homes who put their patients at risk of death or disability for no good medical reason are committing a form of nursing home abuse.

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