Use of Chemical Restraints in Nursing Homes

Recently, three residents died at a skilled nursing facility operated by the Kern Valley Healthcare District. The skilled nursing center has 74 beds and provides 24-hour nursing care. According to a criminal complaint filed by the California Attorney General’s Office against three high-level managers of the facility, the three residents who died, and about 20 other residents, were administered psychotropic drugs for staff convenience by the center’s one-time medical director, the former nursing director, and the former chief pharmacist.

All three individuals have been charged with elder abuse. It is alleged that the nursing director tried to drug almost all of the facility's patients, with the exception of the most compliant residents, and the medical director is alleged to have permitted the nursing director’s orders for medication. The chief pharmacist claimed that she complied with the medication requests because the nursing director had experience working at psychiatric hospitals.

In this case, the individuals used psychotropic drugs, such as Zyprexa, Depakote, and Risperdal, as a means of chemically restraining these nursing home victims. Chemical restraints are defined as the use of psychoactive drugs to treat behavioral symptoms, instead of offering proper care. The residents who were improperly given these drugs suffered multiple side effects, including severe weight loss, slurred speech, loss of cognition, tremors, and psychosis.

One of the residents who had died due to the improper administration of these drugs, was Fannie May Brinkley, who was in her nineties, most likely would have lived for another year or two. She died as a result of the anti-seizure drug Depakote she was forced to take, and neglect of the nursing staff.

The three individuals who administered these drugs are all facing criminal charges, including administering shots by force and without consent, and charges of assault with a deadly weapon. There are also strict federal laws that prohibit this type of behavior by nursing staff.

Federal Law Prohibiting Use of Chemical Restraints

The Nursing Home Patients Bill of Rights (NHPBR) is a federal law that delineates the kind of care nursing home patients, residing in nursing homes that receive Medicare or Medicaid, must abide by. The NHPBR states under 42 Code of Federal Regulations 483.13, subsection (a) that nursing center residents have “the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident's medical symptoms.”

The NHPBR has provisions that mandate facility caregivers to provide an environment that promotes the resident’s quality of life. It also has provisions requiring facilities to have sufficient nursing staff to maintain the highest possible physical and psychosocial well-being of each resident. Additionally, there is a provision regulating pharmacists. Under 42 CFR 483.60, pharmacists must record all drugs that are ordered and a licensed pharmacist must review the resident’s drug regimen at least once a month. If there are any discrepancies, the pharmacist has to report such discrepancies to the attending physician or director of nursing.

The improper use of both chemical and physical restraints against nursing home residents is both unethical and criminally prohibited. They should only be used when a doctor has deemed them as necessary for providing the resident proper care. If someone you know and care about has been improperly restrained and injury has resulted, contact an elder abuse lawyer immediately.