Federal regulators have extended efforts to cut the inappropriate use of medications indicated for schizophrenia, psychosis, and other behavioral health issues. This came after an audit that found about half of nursing homes “misdiagnosed” schizophrenia.

The Centers for Medicare & Medicaid Services (CMS) first announced their intention to review schizophrenia diagnoses among nursing home residents in January 2023. They made this move after noticing a significant increase in schizophrenia diagnoses among this patient population. They suspected that some were unfounded and possibly used to enable people to receive medications to address behavioral symptoms of other illnesses or disorders.

CMS has completed hundreds of schizophrenia audits to date, and many facilities actually admitted making erroneous diagnoses of schizophrenia. The regulators say they found that many diagnoses lacked documentation such as comprehensive psychiatric evaluations, medical evaluations, and behavioral information.

If a facility fails such an audit, their star rating will be reduced for six months; and they must correct any errors or issues identified. Providers are encouraged to work with their pharmacy consultants to identify and take steps to correct potential misdiagnoses and to align with CMS standards.