Illinois Nursing Home Sues CMS Over Schizophrenia Audit & Quality Rating Downgrade

An Illinois nursing home is suing the Centers for Medicare & Medicaid Services (CMS) after an audit of schizophrenia diagnoses and antipsychotic medication use led to lower quality ratings. Forest City Rehab and Nursing Center in Rockford alleges that CMS imposed the rating changes without giving it an opportunity to challenge the findings. The facility claims the lower ratings have affected its Medicaid reimbursement, payer contracts, and incentive payments, resulting in more than $200,000 in financial and reputational damages.

The lawsuit stems from a CMS audit program launched in early 2023 to identify nursing homes that may be incorrectly . . .