Use of antipsychotics in nursing homes is a safety issue: HHS OIG

Nursing homes continue to administer psychotropic drugs to a large percentage of residents for more than a decade after regulators began scrutinizing how drugs are used, the Department of Health and Human Services’ Office of the Inspector General said Monday.

Eight out of 10 long-stay Medicare nursing home residents received psychotropic medication from 2011 to 2019, the OIG HHS found in a review of Medicare data. Inhabitants of institutions with a low staffing level and a high proportion of the poor are more likely to receive psychotropic drugs.

The Centers for Medicare and Medicaid Services have moved into the use of antipsychotics in nursing homes following a critical OIG report published in 2011. Oversight in different administrations of Presidents Barack Obama, Donald Trump and Joe Biden was carried out in different ways.

The OIG also determined that nursing home reports of how many patients have schizophrenia were inconsistent with Medicare’s 2015 to 2019 mental health drug requirements. The number of unconfirmed schizophrenia diagnoses actually rose in 2019, the latest year analyzed by the OIG. but the increase was focused on 99 sites.

CMS’ tracking of antipsychotic drug use in nursing homes excludes residents with schizophrenia, which could allow nursing homes to misreport diagnoses while continuing to prescribe medication and achieve higher quality scores, the independent federal watchdog reports.

One of the five-star nursing homes had 36 patients with schizophrenia registered in 2019, but only three patients had Medicare-related claims supporting the diagnosis. According to the OIG, 29 of them were prescribed antipsychotics. report.

The Office recommends that CMS further evaluate the use of psychotropic drugs in nursing homes, determine which institutions use these drugs most often, and collect data on Medicare Part D diagnoses.

Biden has vowed to step up oversight of nursing homes, in part because of the high number of COVID-19 cases and deaths in long-term care facilities.

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