Facing new CMS pressure, providers should audit mental health diagnoses, prescriptions: expert

07/24/25 at 03:00 AM

Facing new CMS pressure, providers should audit mental health diagnoses, prescriptions: expert 
McKnights Long-Term Care News; by Kimberly Marselas; 7/22/25 
As reported in McKnight’s Long-Term Care News on July 23, “Nursing homes should be auditing documentation for all residents with mental health disorders to ensure their diagnoses are compliant with new federal guidance, a well-known clinical reimbursement recommended Tuesday. Leigh Ann Frick, president of Care Navigation Consulting, made that suggestion while reviewing updated Long-Term Care Surveyor Guidance that went into effect in late April. At over 900 pages, the new manual and appendixes have left many providers still navigating the changes and how best to respond to them. When it comes to giving antipsychotic medications, diagnosing patients with disorders that require them, or identifying and responding to any other patient needs, the guidance puts new emphasis on the use of professional standards, Frisk explained. 
Guest Editor’s Note, Judi Lund Person:  For nursing home residents who have elected the Medicare hospice benefit, this information may apply. Diagnosing mental health issues, prescribing, and documenting based on professional standards is an important component in the updated Long-Term Care Surveyor guidance issued in April.

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