CMS issued guidance (1/18/2023) related to evidence of an increase in schizophrenia diagnoses following a report from the U.S. Department of Health and Human Services Office of Inspector General that found there was a 194% increase in the number of residents diagnosed with schizophrenia who did not have that diagnosis prior to admission to the nursing home (from 2015-2019.) It is rare for schizophrenia to suddenly occur in older people, but the diagnosis does allow for the use of psychotropic drugs.  The report directly connected illegal drugging of nursing home residents with inadequate staffing in nursing homes.

The CMS announcement will direct audits of nursing homes with high rates of schizophrenia diagnoses and “examine the facility’s evidence for appropriately documenting, assessing, and coding a diagnosis of schizophrenia.” Facilities that have “inaccuracies” will have their Quality Measure Rating adjusted.

Additionally, CMS Will Now Post Citations Under Dispute in the Care Compare website. Previously, violations or citations that are in the dispute process were not posted. The new policy gives consumers more information about possible deficiencies in care in nursing homes.

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