Have You Had a Schizophrenia Audit? LeadingAge National Wants to Hear from You

(July 30, 2024) LeadingAge National is looking for feedback from nursing home members who have been identified by the Centers for Medicare and Medicaid Services (CMS) for a schizophrenia audit. CMS began conducting schizophrenia-focused surveys back in 2016 to address the issue of erroneous coding of schizophrenia on the Minimum Data Set (MDS) assessment. CMS presumed this erroneous coding to be an attempt to offset the use of antipsychotic medications and their impact on the Quality Measures ratings. In January 2023, CMS announced that they would begin conducting off-site audits, with penalties for nursing homes in which CMS contractors determined that the diagnoses could not be substantiated. Concerns have been raised about these audits, and LeadingAge National would like to hear from you about your experiences. If you have been identified by CMS/its contractors for a schizophrenia audit, whether you opted to participate in the audit or to sign the attestation to forgo the audit, please reach out to Jodi Eyigor at jeyigor@leadingage.org. Your feedback will help to inform LeadingAge National’s advocacy to CMS on this issue.