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Nursing Homes Accused of False Diagnoses To Hide Drug Use
- March 23, 2026
- HealthDay Staff HealthDay Reporter
A new report says some U.S. nursing homes may be falsely diagnosing patients with schizophrenia in order to justify using powerful antipsychotic drugs to manage them.
The findings come from the Office of Inspector General (OIG) at the U.S. Department of Health and Human Services (HHS), which reviewed inspection reports from 40 nursing homes.
Investigators say the practice may be used to hide how often facilities give antipsychotic drugs to residents with dementia.
“We found that nursing homes inappropriately diagnosed schizophrenia to mask their misuse of antipsychotic drugs, artificially inflate their star rating, and skirt established safeguards meant to protect residents,” the report said. “As a result, nursing homes compromised residents’ care.”
Nursing homes are rated in part on how often they use antipsychotic drugs. If a patient has schizophrenia, it doesn’t count against them in government quality measures, The Washington Post said. The report says some homes may be adding the diagnosis to improve their ratings on the Medicare website.
These medications are not approved for Alzheimer’s disease or other types of dementia, and they carry serious risks, including falls, strokes and death.
Still, doctors can prescribe them "off-label," and they are sometimes used when a patient becomes too aggressive or unsafe.
Critics have long warned that the drugs are overused.
The report found that some residents received these medications even when their behavior was not dangerous.
“At times, residents with dementia received antipsychotic drugs for exhibiting behaviors that the nursing homes themselves acknowledged were not dangerous or distressing to the resident,” it said.
In one case, a woman over 100 years old was given an antipsychotic because she liked caring for dolls.
In another, a man was medicated because he preferred staying in bed instead of sitting in a wheelchair.
A separate case involved a woman who became upset when staff did not respond quickly to her call light.
The report said drugs were sometimes used to manage "harmless behaviors such as repeatedly asking for help or trying to calm themselves."
In a separate report, the OIG found that staff often gave these medications without first trying other approaches, like calming techniques or putting patients in a different environment.
Some staff told inspectors the drugs were used to make patients easier to manage in general.
The investigation also described how some facilities added diagnoses to patient records.
In some cases, electronic systems flagged patients taking the drugs without a schizophrenia diagnosis, prompting staff to tell clinicians to add one.
“On a single day at one nursing home, a nurse practitioner added schizophrenia diagnoses to the records of dozens of residents given antipsychotic drugs,” the report said.
Oftentimes, families were not told about the new diagnosis, investigators found.
The report also raised concerns about some medical directors approving diagnoses without reviewing records or fully evaluating patients.
The American Health Care Association (AHCA), which represents nursing homes, said the report does not represent everyone.
“These OIG reports are based on a very small subset of specifically selected nursing homes and are not indicative of national trends,” Holly Harmon, a senior vice president of AHCA, told The Post.
“Antipsychotic medications are sometimes deemed necessary and beneficial to certain residents based on their clinical condition and shared decision-making with the resident and their medical provider,” she added.
Other groups criticized the practices.
“The antipsychotic misuse and masking outlined ... are inexcusable,” said Jodi Eyigor, vice president of health policy at LeadingAge, which represents more than 5,300 nonprofit providers that serve older people.
Patient advocates also raised concerns.
“The inspector general reports are devastating, confirming that nursing homes continue the decades-long problem of misusing antipsychotic drugs to control residents,” Toby Edelman, an attorney at the Center for Medicare Advocacy, said.
SOURCE: The Washington Post, March 19, 2026
