Changes in Resident and Facility Risk Factors for Psychotropic Drug Use in Nursing Homes Since the Nursing Home Reform Act

The purposes of this article are to identify resident and facility risk factors for the use of psychotropic drugs since the implementation of the Nursing Home Reform Act (NHRA) and to compare these results with resident and facility risk factors prior to the implementation of the NHRA. The results update our knowledge of resident risk factors for psychotropic drug use and identify important but previously unexplored facility risk factors for their use. No evidence was found that particular types of nursing homes, such as for-profits, were systematically more likely to use psychotropic drugs. There was some evidence to suggest that operating characteristics of nursing homes, such as Medicaid census, are more influential in changing psychotropic drug use. In addition, both resident and facility risk factors for psychotropic drug use differed pre and post-implementation of the NHRA. Antipsychotic drug use increased slightly during this study period.