The federal government says it will begin a targeted crackdown on nursing homes\u2019 abuse of antipsychotic drugs and misdiagnoses of schizophrenia in patients.
\nThe Centers for Medicare and Medicaid Services is launching investigations this month into select nursing homes, aimed at verifying whether patients have been properly diagnosed with the psychiatric disorder.
\nEvidence has mounted over decades that some facilities wrongly diagnose residents with schizophrenia or\u00a0administer antipsychotic drugs to sedate them, despite dangerous side effects that could include death, according to the agency.
\n\u201cNo nursing home resident should be improperly diagnosed with schizophrenia or given an inappropriate antipsychotic,\u201d Health and Human Services Secretary\u00a0Xavier Becerra\u00a0said in a statement Wednesday. \u201cThe steps we are taking today will help prevent these errors and give families peace of mind.\u201d
\nSome facilities may be dodging increased scrutiny around gratuitous use of antipsychotic medications by coding residents as having schizophrenia, even when they do not show signs of the extremely rare disorder, a government report last year found. Less than\u00a01% of the population\u00a0is believed to have schizophrenia, which is marked by delusions, hallucinations and disordered thinking.
\nIn 2012, the federal government began tracking when nursing homes use antipsychotics on residents \u2014 doing so can impact the facility\u2019s\u00a0quality rating in a public database\u00a0\u2014 but only for those who have not been diagnosed with schizophrenia.
\nAntipsychotics for those nursing home residents has dropped to under 20% in recent years, according to federal data.
\nA November\u00a0report from the HHS Office of the Inspector General, however, revealed that the number of residents reported as having schizophrenia without a corresponding diagnosis skyrocketed between 2015 and 2019, with 99 nursing homes in the country reporting that 20% or more of their residents have the disorder.
\n\u201cThe number of unsupported schizophrenia diagnoses increased and in 2019 was concentrated in relatively few nursing homes,\u201d the report concluded.
\nNursing homes have worked on other ways to treat residents, especially those with dementia, and trained staff to use alternative methods, said Katie Smith Sloan, the CEO of LeadingAge, an association of nonprofit aging service providers.
\n\u201cMuch has been achieved since the program\u2019s start in 2012, and nursing homes deserve a lot of the credit for the progress,\u201d she said in a statement.
\nCMS will start targeted audits to ask nursing homes for documentation of the diagnoses in the coming days, focusing on nursing homes with existing residents who have been recorded as having schizophrenia.
\nThe rating scores for nursing homes that have a pattern of inaccurately coding residents as having schizophrenia will be negatively impacted, CMS said in a statement released Wednesday, stopping short of threatening to levy fines against facilities.
\nDinging nursing homes\u2019 public ratings will be effective in some cases, said Dr. Shekinah Fashaw-Walters, a researcher at the University of Minnesota who has found that schizophrenia diagnoses have risen in Black nursing home patients compared with their white counterparts in recent years.
\nShe is hopeful that the CMS audits will help to narrow that racial disparity and said that it\u2019s \u201cabout time\u201d for CMS\u2019 plan.
\n\u201cIt\u2019s time to do this and really hold nursing homes accountable for providing high quality care,\u201d she said. \u201cI\u2019m thrilled to see that they are taking these steps, and I think they\u2019re very warranted.\u201d
\nThe agency does not have plans to immediately intervene in the patients\u2019 care directly or notify relatives of residents who have been wrongly coded or given antipsychotics, according to senior HHS officials who insisted on anonymity to brief The Associated Press on the matter on Tuesday.
\nCMS will monitor the facilities to make sure the issues are corrected, officials said.<\/p>\n