Hi, I’m Jordan Rau, a senior correspondent at KFF Health News. I report on medical quality, cost, and patient safety in the U.S. healthcare system. You can contact me at JRau@kff.org.
By Jordan Rau
Potent sedating medications are often given to agitated people with dementia in long-term care facilities despite federal efforts to discourage them.
The FDA warns that antipsychotic medications, originally targeted for schizophrenia, increase the risk of death in older people, but they are frequently used to quell agitation and aggressive behaviors in people with Alzheimer’s and other conditions that cause dementia. It’s particularly an issue in memory care units dedicated to such patients.
A clash over whether to drug a Michigan woman illuminates the wrenching decisions families and guardians face. Marjorie Tingley, 85, lived in the memory care unit of Vista Grande Villa, a senior living community in Jackson. In late 2024, when Vista Grande said she had started hitting or kicking at aides trying to change her briefs and get her bathed, the facility insisted she be given sedating medication, according to documents filed in a court case and her medical records.
After her two sons with power of attorney resisted, fearing the FDA’s drug warnings, Vista Grande began calling 911 to have her taken to a hospital emergency room for mental health evaluations, medical records show. Vista Grande said it was necessary to protect its residents and workers. Her family alleged in court papers the ER trips — totaling eight over five weeks — were retaliation for their refusal to authorize the drugs.
Vista Grande ultimately gave Tingley a 30-day eviction notice, but even before the deadline, after the last hospital trip, the facility refused to accept her back, medical records show. Her family moved her to another memory care facility and she died from Alzheimer’s shortly afterward, the records show. A state judge dismissed the family lawsuit’s allegation of negligence, while two other allegations, of wrongful eviction and causing emotional distress, are slated to go to trial next year. Vista Grande has denied all allegations. Its lawyers did not respond to requests for comment.
The Tingley case highlights many of the biggest challenges in memory care facilities, including the prevalence of resident-on-resident altercations and concerns that underlying causes of aggressive behavior in people with dementia aren’t properly identified. It also shows some of the limits of the Centers for Medicare & Medicaid Services’ campaign to reduce the excessive use of antipsychotic medications in nursing homes.
CMS’ Partnership to Improve Dementia Care started in 2012, and antipsychotic use in nursing home residents not diagnosed with schizophrenia decreased from 24% in 2011 to 14% in 2025. But researchers looking at prescribing trends through 2017 found the campaign “did not appear to affect antipsychotic prescribing” in assisted living facilities like Vista Grande. Those places are regulated by states, not the federal government. A study published in 2023 found that, on average, assisted living residents with dementia were prescribed an antipsychotic for 13% of the time they lived there.
Environmental Health
These 100 Nursing Homes Face Perilous Flood Risk. Minnesota Shows What Can Happen. By Brett Kelman, Holly K. Hacker, and Daniel Chang, KFF Health News, and Frankie McLister and Jason Rantala, WCCO / CBS News Minnesota
Staff raced against rising floodwater to evacuate 36 residents from a nursing home in New Richland, Minnesota. It’s one of 100 facilities KFF Health News identified as facing some of the nation’s worst flood risk.
Elections
Rural MAHA Followers Say Trump Health Policies Haven’t Reached Their Communities By Ali Swenson and Linley Sanders, The Associated Press, and Sarah Jane Tribble, KFF Health News
President Donald Trump has championed sprawling health policy changes under the Make America Healthy Again movement, but a KFF-Associated Press survey of rural voters found people aren’t seeing the initiatives reach their communities.
An Illinois woman spent hours waiting in an emergency room, never receiving treatment before deciding to try a different hospital. The ER billed her anyway. Swipe through this Instagram summary to learn more, and read the article.
Do you have a medical bill that is exorbitant, baffling, infuriating, or all of the above? Send it to us and tell us about your experience.
Follow KFF Health News online as we break down healthcare headlines and policy:
Medicaid
Confusion and Angst Follow State’s Early Rollout of Medicaid Work Rules By Aaron Bolton, MTPR
In most states, people with Medicaid coverage will have to prove they’re working, volunteering, or studying starting Jan. 1. But Montana put the rules into effect early, and they’re sowing uncertainty and anxiety.
US Poised To Boot Legal Immigrants From Medicaid, Including Refugees and Sex-Trafficking Victims By Phil Galewitz, Andrew Jones, and Claudia Boyd-Barrett
The Congressional Budget Office estimated 100,000 more immigrants will be uninsured by 2034 because of Medicaid eligibility changes under Trump’s One Big Beautiful Bill Act that take effect Oct. 1. A KFF Health News survey of nine states found many more are at imminent risk of losing health coverage.
Workforce
After Failed Execution, Health Workers Say State’s Rules Flout Medical Ethics By Catherine Sweeney, WPLN
The death penalty is legal in 27 states, and lethal injection is the primary method. That means involving medical professionals to store, test, and inject the drugs. After a botched execution in Tennessee, doctors and nurses there say medical professionals need to be removed from the process completely.
'Denied'
Patient Dies by Suicide After ‘Insurance Issue’ Delayed Medicine for Lung Disease Flare-Ups By Lauren Sausser
Hours after experiencing a flare-up related to chronic obstructive pulmonary disease, Kenney Blewett of Kyle, Texas, died by suicide in June. A medication his doctor prescribed days earlier to ease his breathing problems hadn’t been filled due to an “insurance issue,” his pharmacy explained via email.
Do you have an experience navigating prior authorization to get medical treatment that you’d like to share with us for our reporting? Share your story.
'Common Ground'
(Earl Neikirk for KFF Health News)
Republicans and Democrats Find a Unifying Target: Pharmacy Benefit Managers By Blake Farmer, Nashville Public Radio
Some states have considered barring companies that own a PBM from also owning brick-and-mortar pharmacies, as CVS does. Two states have followed through. A similar proposal at the federal level has gained prominent sponsors, aligning conservative, business-friendly Republicans with Democrats traditionally more open to government regulation.
'What the Health? From KFF Health News': The MAHA Metamorphosis
The Make America Healthy Again movement held a shindig in Washington, D.C., this week. But rather than moms arguing to get chemicals out of their kids’ food, the room was full of Trump administration officials and industry representatives looking to promote health-related products. Meanwhile, the administration for the second year in a row is refusing to spend money Congress appropriated. Shefali Luthra of The 19th, Rachana Pradhan of KFF Health News, and Rachel Roubein of The Washington Post join KFF Health News’ Julie Rovner to discuss these stories and more. Also, Rovner interviews Aaron Carroll of AcademyHealth.
Halloween Healthcare Haiku Contest
(Oona Zenda / KFF Health News)
Healthcare Is Scary. Channel Your Fears Into a Haiku. By KFF Health News Staff
Think you can terrify us in 17 syllables? KFF Health News’ eighth annual Halloween haiku contest is now open. Send us your most haunting healthcare verses.
If you’re an older patient taking a long list of medications, consider reviewing them with a primary care provider to make sure they’re helping more than hurting. Plus, states are experimenting with Medicaid meal deliveries to cut costs and improve patients’ health.
KFF Health Newsis a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
(c) 2026 KFF. All rights reserved.
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