Feds launch probe into nursing homes accused of drugging vulnerable residents with deadly schizophrenia drugs dubbed 'chemical straight jackets' to sedate them

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The federal government will crack down on nursing homes accused of drugging residents with powerful antipsychotic meds to keep them sedated.

The Centers for Medicare and Medicaid Services is launching investigations this month into facilities that allegedly misdiagnosed residents and gave them schizophrenia drugs dubbed by some psychiatrists as 'chemical straightjackets'.

CMS did not immediately disclose how many nursing homes will be targeted, but the agency oversees roughly 15,500 skilled nursing facilities in the US, all of which are susceptible to an audit. 

The agency's investigations come more than a year after a bombshell report showed 21 percent of nursing home residents are on sedating antipsychotic medications. 

CMS Administrator Chiquita Brooks-LaSure acknowledged that more needs to be done to stop nursing homes from improperly administering anti-psychotics, but the agency will not immediately intervene in the patients' care directly

HHS Secretary Xavier Becerra said on Wednesday: 'The steps we are taking today will help prevent these errors and give families peace of mind'

Often in nursing homes, older adults and people with disabilities are prescribed sedating medications such as antipsychotics as a way to manage disruptive behavior.

Side effects of the drugs vary by person, but they have been associated with an increased stroke risk and overall mortality in people with dementia. 

CMS Administrator Chiquita Brooks-LaSure said on Wednesday:  'We have made significant progress in decreasing the inappropriate use of antipsychotic medications in nursing homes but more needs to be done. 

'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 medications.'

Facilities found to have incorrectly diagnosed a resident with schizophrenia, a mental disorder characterized by thoughts or experiences that seem out of touch with reality, and affects memory, and a person's ability to think, feel, and behave clearly. 

Experts slam US nursing home system as 'ineffective' 

A report published by the National Academies of Science, Engineering, and Medicine (NASEM) said the pandemic exposed issues in America's nursing home system that had plagued it for years.

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The chronic disorder is rare, afflicting less than one percent of the U.S. population. Seniors with schizophrenia often have co-occuring illnesses such as cardiovascular disease or dementia. 

Federal regulators are aware of the risk that antipsychotic drugs pose to seniors. In 2008, the Food and Drug Administration issued a blackbox warning for antipsychotics stating: 'the treatment of behavioral disorders in elderly patients with dementia with … antipsychotic medications is associated with increased mortality.'

Evidence has mounted over decades that some facilities wrongly diagnose residents with schizophrenia or administer antipsychotic drugs to sedate them, despite dangerous side effects that could include death, according to the agency.

The Department of Health and Human Services Office of Inspector General  revealed in a 2011 report that 14 percent of elderly nursing home residents had Medicare claims for second generation antipsychotic drugs, and 88 percent of those were prescribed for dementia despite the FDA’s warnings.

In November, that same office reported: 'Over time the number of unsupported schizophrenia diagnoses increased and in 2019 was concentrated in relatively few nursing homes. 

'Specifically, we found that from 2015 through 2019 the number of residents reported in the MDS as having schizophrenia but lacking a corresponding schizophrenia diagnosis in Medicare claims and encounter data increased by 194 percent.' 

Secretary Xavier Becerra said: 'No nursing home resident should be improperly diagnosed with schizophrenia or given an inappropriate antipsychotic. The steps we are taking today will help prevent these errors and give families peace of mind.'

Facilities found guilty of dosing patients will suffer the consequences in the form of poor quality ratings using the agency's comprehensive nursing home directory. 

If an audit identifies that a nursing facility has a pattern of inaccurately diagnosing its residents as having schizophrenia, its Five-Star Quality Measure Rating on CMS' Care Compare site will be downgraded to just a single star, a potentially huge blow to the facilities' bottom lines. 

CMS will continue to monitor each facility’s data to determine whether they have addressed the issues identified in the audits. 

In 2012, the federal government began tracking when nursing homes use antipsychotics on residents — doing so can impact the facility's quality rating in a public database — but only for those who have not been diagnosed with schizophrenia.

The agency does not have plans to immediately intervene in the patients' care directly or notify relatives of residents who have been wrongly coded or given antipsychotics, according to senior HHS officials who insisted on anonymity to brief The Associated Press on the matter on Tuesday.