A growing number of senior living communities are dealing with addiction and mental health problems that they aren’t always equipped to handle.
Skilled Nursing News recently reported that nursing home operators are seeing more residents with psychiatric conditions, dementia-related behaviors, substance use disorders and other complex needs.
The problem goes beyond the resident’s health. Behavioral issues can affect falls, injuries, staffing and the results of state surveys. Facilities can also struggle to get enough reimbursement to cover the extra care some residents need.
That matters to people looking for addiction treatment too. Mental health and substance use often overlap and those issues don’t disappear when someone moves into a skilled nursing facility.
Why Mental Health Is Part of Nursing Home Care
Cory Woods, the chief clinical officer at Rockport Healthcare Services, told Skilled Nursing News that facilities should look closely at a person’s behavioral health history before accepting a referral.
That means asking about trauma, substance use and psychiatric conditions along with other complex behavioral needs.
Rockport operates more than 70 nursing homes in California. According to the report the company has seen more residents who need behavioral health services.
Some are younger people with psychiatric conditions. Others are older residents dealing with dementia and behavioral symptoms. Substance use disorders are another part of the picture.
The needs can look very different from one resident to another. The challenge for a facility is figuring out whether its staff and resources are enough to handle them safely.
How Care Affects Costs
Behavioral health can also affect a facility’s finances. The Skilled Nursing News report says surveyors may question whether a diagnosis such as schizophrenia is appropriate.
That can affect a facility’s quality metrics. Certain schizophrenia diagnoses can also affect whether a facility is eligible for a risk-based audit program.
Then there is the cost of providing the care itself. Some residents need one-on-one support or more frequent checks.
A facility may also need psychiatric providers social workers or additional staff in the hallways. Some residents need more time to stabilize before they return to their usual level of functioning.
Those resources cost money. Woods said reimbursement plays an important role in giving facilities the resources they need to manage complex behavioral symptoms.
Rockport has gone back to payers for additional support including through California’s CalAIM program for Medi-Cal beneficiaries.
When a facility can’t meet a resident’s needs the consequences can spread beyond that person. The report points to denied payments fines repeat surveys and civil penalties.
Hospitals can also end up with patients waiting longer when there isn’t an appropriate place to send them.
What Facilities Are Changing
Some operators are putting more work into screening before admission. A facility can look at a person’s trauma history substance use psychiatric history and known triggers before deciding whether it can provide the right level of care.
That information can also help staff build a care plan before the resident arrives. The approach has something in common with integrated addiction treatment.
Instead of looking at one diagnosis in isolation the care team considers mental health medical needs and other factors that can affect recovery.
Training is another part of the response. Rockport launched a behavioral management training series in January.
The program teaches staff how to recognize escalation approach residents safely de-escalate situations and know when to call for additional help.
The company also added the training to employee onboarding. With staff turnover a single training session isn’t likely to be enough.
Activities can play a role too. Rockport’s Heart to Serve program has residents prepare food for people experiencing homelessness in their communities.
The activity gives residents something structured to do and can help reduce the boredom that sometimes makes behavioral symptoms worse.
Longer activity hours are part of the same effort. So is training staff to respond when a situation starts to escalate.
What to Ask When Comparing Programs
Most people looking for rehab aren’t thinking about nursing home surveys or reimbursement rules. They should still pay attention to how a program handles mental health.
Addiction often occurs alongside depression anxiety trauma or other behavioral health conditions. A program that screens for those needs and trains its staff to respond is better prepared for patients who need more than addiction counseling alone.
If you’re comparing rehab programs for yourself or a parent ask a few direct questions. How does the program handle mental health treatment alongside addiction care?
Are staff trained in crisis intervention? What happens when someone has dementia or significant behavioral symptoms?
And what does the facility do when a person’s psychiatric needs become more than its staff can manage? The answers can tell you quite a bit about the program.
Finding Treatment Options
Rehab.com lists residential and outpatient programs across the country. You can compare programs by treatment approach payment options and specialty services.
Call
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to discuss treatment options and ask the behavioral health questions that matter before choosing a program.
