What We Know About Schizophrenia Audits

(Sept. 3, 2024) LeadingAge National has recently heard increased concern from members and states about the Centers for Medicare and Medicaid Services’ (CMS) schizophrenia audits. They have reached out to both CMS and the Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) to learn more.

There has been no specific data provided on the number of facilities who have received a schizophrenia audit, or any indication of the number expected to still be performed. LeadingAge National was told that, overwhelmingly, facilities do not have the required documentation to support the clinical diagnosis of schizophrenia, and therefore few facilities are passing these audits.

In an effort to best support facilities facing a schizophrenia audit, LeadingAge National has compiled information and best practices here.

Contact: Carrie Mosley, cmosley@leadingageny.org, 518-867-8383 ext. 147