The Schizophrenia Diagnosis in a Skilled Nursing Facility

If a facility accepts residents with neuro-psych diagnoses as a specialty, the population may be comprised of younger residents with a long-standing diagnosis of schizophrenia. In this case, the residents should have appropriate psychiatric assessments to support the diagnosis.

CMS has been tracking the use of antipsychotics in SNF since 2012 and has identified an increase in the number of residents diagnosed with schizophrenia while a resident.

When residents present with behaviors found in the typical list of schizophrenia symptoms, there must be diagnostic support from appropriate physicians to justify the diagnosis.

If a resident is admitted to the SNF with a diagnosis of schizophrenia from the acute care hospital, or the SNF physician writes the diagnosis of schizophrenia while a resident, the MDS Coordinator and Interdisciplinary Team (IDT) must be on alert.


Learn about the extra CMS requirements when serving a resident with a schizophrenia diagnosis.


If you are concerned about coding and billing as it relates to specific diagnoses, please reach out to Kay Hashagen, PT, MBA, RAC-CT, Senior Consultant at [email protected] or (410) 777-5999.

Should you need assistance with litigation, remember that LW Consulting, Inc. (LWCI) has the experience to help. Our team has consulted on many cases across the healthcare continuum.

We also serve as an Independent Review Organization (IRO) for providers with reporting obligations under a CIA or IA.