The Centers for Medicare and Medicaid Services (CMS) has issued a memo outlining oversight and enforcement measures for nursing facilities that are late-adopters of measures to reduce off-label antipsychotics use. As of January 2019, 235 facilities nationally have been identified as late adopter nursing homes. They have been cited for noncompliance with federal regulations related to unnecessary medications or psychotropic medications two or more times since January 1, 2016, and who have not shown improvement in their long-stay antipsychotic medication rates.

QSO-19-07-NH – Enhanced Oversight and Enforcement of Non-Improving Late Adopters specifies that if late adopters are not in compliance with F-605 Chemical Restraints, F-744 Dementia Care, or F-758 Psychotropic Medications during a survey, they will be subject to enforcement remedies for such noncompliance.

CMS oversight and enforcement efforts include a two-pronged approach. The first approach will involve enhanced oversight and enforcement actions, while the second approach will focus on outreach with corporations that own or operate significant numbers of late adopter facilities.