Ellery Care data study
Antipsychotic drugging in Texas nursing homes
Antipsychotic drugs are sometimes used to sedate nursing home residents with dementia, a practice the FDA warns can be dangerous for older adults. Using CMS quality data (2026-08-09), we looked at how often every rated Texas home gives these drugs to its long-stay residents.
The good news for Texas: the typical home here sits below the national average. The concern: 43 Texas homes still give an antipsychotic to a quarter or more of their long-stay residents. These are the 25 highest rates in the state among homes large enough for the percentage to be stable.
Why this matters
Antipsychotics are approved to treat serious mental illness like schizophrenia. They are not approved to manage the confusion, restlessness, or agitation that often come with dementia. The FDA places its strongest warning on these drugs for older adults with dementia because they raise the risk of death. When a home has a high rate, it can be a sign that staff reach for medication instead of the time and training that dementia care really needs.
What to do if you are worried
A high rate is a reason to ask questions, not to panic. Ask to see your parent's care plan. Ask whether any antipsychotic has a documented diagnosis behind it, what non-drug approaches were tried first, and how often the prescription is reviewed. Families have the right to request a gradual dose reduction in writing.
How we built this
We used the long-stay antipsychotic measure from CMS MDS Quality Measures (retrieved 2026-08-09), the four-quarter average share of long-stay residents who received an antipsychotic medication. We ranked Texas homes with at least 25 residents, so the percentage reflects a real pattern rather than one or two cases. Full details on our methodology page.
Common questions
Why do nursing homes give antipsychotic drugs to dementia patients?
Antipsychotics are approved to treat conditions like schizophrenia. In nursing homes they are sometimes used off-label to calm or sedate residents with dementia, which the FDA warns can raise the risk of death in older dementia patients. CMS tracks the practice as a marker of care quality.
What is a normal antipsychotic rate for a nursing home?
Across Texas the median rate is about 8.3% of long-stay residents, and the national median is about 13.4%. Rates well above those figures, and especially above 25%, are worth asking hard questions about.
What should I do if my parent's nursing home has a high rate?
Ask to see your parent's care plan, ask whether any antipsychotic prescription has a documented medical reason, ask what non-drug approaches were tried first, and ask how often the prescription is reviewed. Families can request a reduction ('gradual dose reduction') in writing.
Checking on a specific home?
Every Texas nursing home report card shows its antipsychotic rate next to its staffing, inspection findings, and fines, with plain-English context.
Source: CMS MDS Quality Measures, long-stay antipsychotic measure, retrieved 2026-08-09. Ellery Care accepts no payment from any facility and is not affiliated with CMS. Educational information, not medical advice. Related: the most-fined nursing homes in Texas.