Columnist Norris Cunnigham discusses infection control penalties.

Q: The use of antipsychotic drugs in nursing homes is already a publicly reported quality measure. Are we headed toward even more scrutiny?

A: Yes, more scrutiny is coming. In February, the Department of Health and Human Services Office of Inspector General updated its Work Plan to include an in-depth review of nursing home citations related to the use of antipsychotic drugs. 

The OIG noted previous instances where it had raised concerns about the use of such drugs in nursing homes and indicated that they would conduct an in-depth review of survey reports to: 1) examine the nature of related nursing home citations and 2) identify vulnerabilities that contribute to the inappropriate use of these drugs. The OIG expects to issue its report in fiscal year 2024. 

The combined efforts of nursing homes, industry groups and governmental agencies led to an almost 40% decrease in the Quarterly Prevalence of Antipsychotic Use for Long-Stay Nursing Home Residents between 2011 and 2021.

Despite this significant decrease, there is more work to be done, and the OIG’s increased scrutiny will inevitably lead to greater focus by state survey agencies on the issue.

Although use of these drugs continues to invite a great deal of scrutiny, they remain essential treatment for residents with certain mental health conditions. 

Nursing homes must be diligent in documenting not just a diagnosis that confirms the need for antipsychotics, but they also must ensure that there are other treatment regimens and methods for the underlying condition that are evaluated and utilized.

Such documentation helps to dispel the notion that the clinical diagnosis was made only for the purpose of prescribing and administering the antipsychotic medications. 

Please send your legal questions to Norris Cunningham at [email protected].