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CMS Assessing Schizophrenia Coding, Publicly Displaying Citations Under Dispute for Nursing Homes

Analysis  |  By Jasmyne Ray  
   February 03, 2023

The additional measures are part of the Biden Administration's efforts to increase accountability for nursing homes.

The U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS), announced additional steps to increase safety and transparency in nursing homes.

The steps are part of the Biden administration's continued efforts to hold nursing home accountable for the quality of care they provide.

In January, CMS began conducting off-site audits to assess whether nursing homes were accurately coding residents with schizophrenia. Those who are misdiagnosed are at risk of being prescribed antipsychotic medication that they don't need, which have dangerous side effects for residents, including death.

"We have made significant progress in decreasing the inappropriate use of antipsychotic medications in nursing homes, but more needs to be done," Chiquita Brooks-LaSure, CMS administrator, said in a statement. "People in nursing homes deserve safe, high-quality care, and we are redoubling our oversight efforts to make sure that facilities are not prescribing unnecessary medication."

In a separate action, CMS has also begun publicly displaying survey citations that nursing homes are disputing. Currently, when facilities dispute a survey deficiency, the deficiency isn't posted to Care Compare until the dispute process has been completed, which usually takes approximately 60 days, if not longer.

As of January 25, deficiencies are being posted to Care Compare while they're being disputed. As the citations are being displayed they won't be included in the calculations for the facility's Five-Star Quality Rating until the dispute is complete.

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