1 in 25 adults struggle with behavioral health issues

PDPM poses new challenges for SNF caregivers

Prior to the new Patient-Driven Payment Model, facilities dealt with a host of difficulties related to behavioral health treatment. More oſten than not, admission and reimbursement requirements were a huge burden, demanding dedicated specialists, complex treatments and, as a result, expensive referrals.

This year, a Skilled Nursing News report indicated that 1 in 3 facilities admitted they were unable to adequately provide behavioral health care. The majority of those same facilities acknowledged these services as having an “impact on admission.”

Our residents exhibit a wide range of behavioral health needs related to dementia and Alzheimer’s, post-traumatic stress, depression, bipolar disorder, adjustment disorder and more. Managing such diverse conditions puts stress on staff, many of whom lack proper education and resources. In the end, the situation puts everyone at risk.

Searching for solutions

In light of the recent CMS changes, administrators and strategists are weighing in on the state of mental and behavioral health care treatment in America’s skilled nursing industry. In particular, changes to billing have many wondering—Are we finally in the clear? What barriers to care can we expect under the new PDPM? Will the situation worsen?

“At MediTelecare, we are beginning to hear from our partners about new challenges they are encountering,” says Bernadette Greatorex, Vice President of Strategic Partnerships & Customer Service. “For example, capturing cognitive impairment early in the resident’s admission can be demanding on staff and may feel burdensome to patients who are just beginning to settle into the facility.”

Others note difficulty using BIMS (Brief Interview for Mental Status). Although generally effective, facilities find that the screening tool is not advanced or accurate enough; patients with early symptoms continue to fall through the cracks. Of course, early detection and treatment are so critical to managing conditions like dementia.

To boost your facility’s BH plan and conform to PDPM standards, experts stress the need for ongoing staff education; early evaluation and treatment; use of comprehensive screening methodologies; consistent recordkeeping of diagnosis updates; among other behavioral health-related initiatives.

Looking to the future, Greatorex seems optimistic: “With the additional financial support brought to skilled nursing facilities by a PDPM, residents will not only benefit from a more integrated care model, but facilities will be able to improve overall patient outcomes.”