The federal government will push down on nursing facilities that are suspected of sedating residents with potent antipsychotic drugs.
The Centers for Medicare & Medicaid Services is initiating investigations this month into institutions that allegedly misdiagnosed residents and prescribed them ‘chemical straightjackets’ for schizophrenia.
CMS did not immediately disclose the number of nursing homes to be audited. But the agency controls around 15,500 skilled nursing facilities in the United States, all of which are subject to audit.
More than a year has passed since blockbuster research revealed that 21 percent of nursing home residents take sedating antipsychotic drugs.
As a means of managing disruptive behavior, older folks and those with disabilities are frequently provided sedatives and antipsychotics in nursing facilities.
Individual differences in pharmacological side effects have been linked to an increased risk of stroke and overall mortality in dementia patients.
CMS Administrator Chiquita Brooks-LaSure stated on Wednesday, ‘We have made substantial progress in reducing the inappropriate use of antipsychotic drugs in nursing homes, but more work remains.
Feds investigate nursing homes
“Nursing home residents deserve safe, high-quality care. And we are redoubling our efforts to ensure that facilities do not prescribe unneeded pharmaceuticals.”
Facilities discovered to have mistakenly diagnosed a patient with schizophrenia, a mental condition defined by ideas or experiences that seem out of touch with reality and which affect memory, as well as the capacity to think, feel, and behave clearly.
Less than one percent of the U.S. population is affected by this chronic illness. Frequently, seniors with schizophrenia also suffer from cardiovascular disease or dementia.
Antipsychotic medicines offer a risk to the elderly, which is known by federal regulators. The Food and Drug Administration issued a black box warning for antipsychotics in 2008. Indicating that ‘the treatment of behavioral disturbances in older individuals with dementia with… antipsychotic medicines is associated with increased mortality.’
According to the government, evidence has accumulated over decades that some facilities incorrectly diagnose inmates with schizophrenia or prescribe antipsychotic medicines to sedate them, despite potentially fatal adverse effects.
In a 2011 investigation, the Office of Inspector General of the Department of Health and Human Services discovered that 14 percent of elderly nursing home residents had Medicare claims for second-generation antipsychotics, and 88 percent of those were given for dementia despite FDA warnings.
This same office noted in November: ‘Over time, the number of unsubstantiated schizophrenia diagnoses increased. And in 2019, they were concentrated in a small number of nursing homes.
From 2015 to 2019, the number of residents who were identified to have schizophrenia in the MDS. But who lacked a corresponding schizophrenia diagnosis in Medicare claims and encounter data increased by 194%.
Feds investigate nursing homes accused of sedated vulnerable people
Secretary Xavier Becerra stated, “No resident of a nursing home should be incorrectly diagnosed with schizophrenia or administered an unsuitable antipsychotic.” The measures we are taking today will assist in preventing these blunders and provide families with peace of mind.
Facilities found guilty of overdosing patients will be penalized with low-quality ratings in the agency’s exhaustive nursing home list.
If an audit reveals that a nursing facility tends incorrectly diagnose its residents with schizophrenia. The facility’s Five-Star Quality Measure Rating on the CMS’ Care Compare website will be lowered to a single star. Which could have a devastating financial impact on the facility.
CMS will continue to monitor each facility’s data to see if the audit-identified issues have been resolved.
In 2012, the federal government began recording when nursing homes administer antipsychotics to residents. Which can affect the facility’s quality rating in a public database, but only for individuals without a schizophrenia diagnosis.
According to top HHS officials who briefed The Associated Press on Tuesday under the condition of anonymity. The agency has no immediate plans to intervene directly in the care of the patients. Or to notify relatives of residents who were incorrectly categorized or administered antipsychotics.