The Department of Heath and Human Services (HHS) Wednesday announced an initiative to reduce the “inappropriate” use of antipsychotic drugs in US nursing homes. HHS Secretary Xavier Becrerra linked the improper drug use to erroneous schizophrenia diagnoses and argued that patients without an accurate diagnosis who take antipsychotics are at higher risk for poor care. The medications also have potentially harsh side effects, including impaired mobility, loss of cognitive functions and in severe cases, death.

HHS in conjunction with the Centers for Medicare & Medicaid Services (CMS) will begin targeted off-site inspections of nursing homes this month. The inspections will focus on the accurate diagnoses of patients receiving antipsychotic medication for schizophrenia. A facility found to be incorrectly prescribing such medication will receive a negative rating on the CMS Five-Star Rating System. The rating system is publicly available to assist families and caregivers make informed decisions regarding elder care.

The targeted inspections are part of a larger push by the Biden administration to hold nursing homes accountable for the care their residents receive. Research by the JAMA Network medical journal shows private sector equity firms are purchasing large numbers of nursing facilities. These firms often increase patient Medicare and Medicaid costs while reducing positive outcomes.

Additionally, the administration identified inadequate staffing levels and quality-trained care as major issues facing the nursing home industry. Policies including a national pathway to nursing careers and connecting federal medicaid reimbursement to staff wages and benefits are suggested. California and Hawaii recently initiated state-level legislation designed to protect the elderly.

Nursing homes in the US faced high death rates and staff turnover early on in the COVID-19 pandemic. Around 25 percent of all recorded pandemic related deaths in the US occurred in nursing home facilities.