The federal government claims it will start a targeted crackdown on antipsychotic drug abuse in nursing homes and patient misdiagnoses of schizophrenia.
This month, the Centers for Medicare and Medicaid Services will begin looking into a few nursing facilities to see if patients have received the correct psychiatric diagnosis.
According to the government, there is mounting evidence that some facilities misdiagnose patients as having schizophrenia or sedate them with antipsychotic medications despite potentially fatal adverse effects.
Health and Human Services Secretary Xavier Becerra said in a statement on Wednesday that “no nursing home resident should be erroneously diagnosed with schizophrenia or given an unsuitable antipsychotic. The actions we are taking today will aid in the prevention of these mistakes and provide families with comfort.”
According to a federal investigation from last year, some facilities may be avoiding heightened scrutiny over the unnecessary use of antipsychotic prescriptions by diagnosing patients as having schizophrenia even when they do not exhibit symptoms of the relatively rare condition. Schizophrenia is a mental illness that affects less than 1% of people and is characterized by delusions, hallucinations, and distorted thinking.
Only for individuals who have not been diagnosed with schizophrenia, the federal government started keeping note of when nursing homes utilize antipsychotics on residents in 2012. This practice can affect the facility’s quality rating in a public database.
According to federal data, the percentage of nursing home residents who take antipsychotics has decreased to under 20% in recent years.
However, according to a report released in November by the HHS Office of the Inspector General, the proportion of residents reported to have schizophrenia without a corresponding diagnosis increased dramatically between 2015 and 2019, with 99 nursing homes across the nation reporting that 20% or more of their residents suffer from the condition.
The report’s conclusion said that “the number of unsubstantiated schizophrenia diagnoses rose and in 2019 was concentrated in a small number of nursing institutions.”
According to Katie Smith Sloan, CEO of LeadingAge, an association of nonprofit providers of services for older people, nursing homes have developed additional ways to treat clients, particularly those who have dementia, and have taught staff to adopt alternative approaches.
According to her statement, “Much has been accomplished since the program’s launch in 2012, and nursing homes deserve a great deal of the credit for the accomplishment.”
In the coming days, CMS will begin targeted audits to ask nursing facilities for proof of diagnosis, concentrating on nursing homes with current residents who have been diagnosed with schizophrenia.
In a statement issued on Wednesday, CMS stopped short of threatening to levy fines on facilities and said that the rating scores for the nursing homes that have a record of incorrectly classifying people as having schizophrenia will have a negative impact.