When you search for a nursing home for your parents or grandparents, you look for the markers of safety, a clean lobby, a friendly face, and that coveted five-star rating from the federal government. You aren’t just looking for a room — you’re looking for a sanctuary where they can live out their final years with dignity. But behind those high ratings, a darker reality often hides.

The Office of Inspector General has uncovered a practice that is harming the elderly while boosting their Centers for Medicare & Medicaid Services’ “Star Ratings.” Based on surveyors’ direct observations, records, and interviews with staff, residents, and family members, a comprehensive review of over 40 nursing home inspections found several instances where these care facilities were inappropriately diagnosing residents with schizophrenia.