The elderly in nursing homes are particularly vulnerable patients, entirely dependent on the good sense and good will of professional care givers. Hence the question of giving anti-psychotic drugs to aggressive dementia patients to calm them down and basically give less trouble to care givers. As much as 88% of these wrong prescriptions are claimed from Medicare according to a Government audit. The inappropriate use of anti-psychotic medications lead to death in dementia patients as indicated in several past research projects which is why the FDA does not allow its use.
So where is the innovation gap? It probably is in the basics of not considering the customer (patient in this case) first. An elderly person is in a nursing home because he/she needs professional care. The nursing home establishment obviously does not put the patient first and goes in for inappropriate use of medicines just so that it is easier to deal with a chemically "restrained" patient. And keep in mind that dementia is the sixth leading cause of death in the US.
Perhaps it is important to segments patients carefully and then treat them as first piece in healthcare. Its just too late if insurance/medicare refuses payment for wrong medications because by then the harm to the patient is done.