The Biden administration plans to crack down on the inappropriate use of antipsychotics in nursing homes and the misdiagnosis of patients with schizophrenia, the Centers for Medicare and Medicaid Services (CMS) said Wednesday. .
CMS will conduct targeted audits starting this month to determine whether nursing homes are accurately evaluating and coding individuals diagnosed with schizophrenia, the agency said.
This initiative is part of a larger government effort to improve the safety and quality of care in nursing homes, ensure adequate staffing, and hold nursing homes accountable when they provide unsafe care. am.
There is increasing evidence from nursing home safety advocates that facilities are improperly diagnosing patients and over-prescribing antipsychotics as a way to sedate them.
“We have made great strides in reducing the inappropriate use of antipsychotics in nursing homes, but more needs to be done,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “People in care homes deserve safe, quality care, and we are redoubled in our monitoring efforts to ensure that care homes do not prescribe unnecessary medications.”
Nursing home residents who are misdiagnosed with schizophrenia are at risk of inadequate care and are prescribed inappropriate antipsychotics, CMS said. Drugs are especially dangerous among people in nursing homes because of their potentially devastating side effects, including death.
Nursing home resident antipsychotic use is an indicator of nursing home quality and is used in the 5-star rating of nursing homes. However, because the rating excludes residents with schizophrenia, they are incentivized to code as having schizophrenia even if the resident does not.
“Nursing home residents should not be improperly diagnosed with schizophrenia or given inappropriate antipsychotic medications. The steps we are taking today prevent these errors. , helps provide peace of mind to families,” Department of Health and Human Services (HHS) Secretary Xavier Becerra said in a statement.
The federal government has worked to reduce the use of powerful antipsychotics (a type of psychotropic drug) among nursing home patients.
About 80% of Medicare long-term nursing home residents were prescribed psychotropic drugs from 2011 to 2019, according to a government watchdog report published in November.
But despite efforts to reduce antipsychotic use, prescribing of another type of psychotropic drug, the antiepileptic drug, has increased, presumably to reduce regulatory scrutiny, says the HHS Commissioner. report found.
Additionally, the number of residents with undiagnosed schizophrenia increased 194% from 2015 to 2019 and was concentrated in a relatively small number of care homes.
In 2019, unsubstantiated reports of schizophrenia were concentrated in 99 nursing homes in the country, with more than 20% of residents reported to have schizophrenia.
Rating scores for nursing homes with patterns of inaccurately coding residents as schizophrenic would be negatively impacted, according to CMS.
