The Office of Inspector General recently released troubling findings that reveal a spike in psychotropic drug prescriptions in nursing homes nationwide. From 2011 to 2019, approximately 80 percent of Medicare’s long-stay facility residents were prescribed antipsychotics.
Higher use of this drug has been linked to nursing homes with lower levels of registered nurses on staff and an increase in residents receiving low-income subsidies.
Even more alarming was the increased number of unsupported schizophrenia diagnoses in Medicare claims growing by 194 percent between 2015 and 2019. Most of those residents resided in 99 nursing homes. More than 20 percent of those “diagnosed” showed no signs of the disease in the resident’s Medicare claims history.
In reality, schizophrenia is a rare affliction that results in delusions, hallucinations, and disordered thinking. Less than one percent of the overall population suffers from it.
The lack of diagnoses on Medicare Part D claims limits the Centers for Medicare & Medicaid Services (CMS) ability to effectively oversee psychotropic medication. Without confirmed diagnoses, identifying risks to patients and patterns of inappropriate drug use creates challenges for the CMS in determining drugs used for medically accepted purposes.
In response to this growing problem, the federal government announced a plan to conduct investigations on nursing homes, focusing on their purported overuse of antipsychotic drugs abuse and the number of schizophrenia misdiagnoses in patients. As part of the review, investigators from the CMS will conduct onsite audits.
Nursing homes are entrusted with caring for the most vulnerable in our society. Caring for them requires the highest standards of quality and compassion. Falling short shatters trust, devastating loved ones betrayed by care facility staff and management.