Given all the attention the Centers for Medicare & Medicaid Services has streamed on skilled nursing lately, the agency will surely expect more from providers on the behavioral front, too.
Many operators have started to prepare for more frequent mental health needs, building out networks and partners who can help identify specific behavioral needs of skilled care patients. Spotting changes in cognition and memory is just the start. CMS also will put more emphasis on addressing pain and substance abuse, and delivering quality treatments — and not just through medication.
The agency has said it wants providers to:
• Broadly improve access and quality of mental healthcare and services
• Provide better access to substance use disorders prevention and treatment across settings, to include nursing homes where such patients may come to recover from short-term health conditions
• Ensure effective pain treatment and management
• Promote equity and person-centered care that addresses language barriers and cultural needs.
• Use data for effective actions and impact
How all of this will play out for nursing home operators is unclear. But there can be little hope that the spikes in depression, anxiety and other mood disorders associated with the pandemic will resolve themselves. We are a more-stressed nation, living in a more stressful time in a stressed-out world.
How many nursing homes have resisted taking patients with coexisting but controlled behavioral health disorders because they fear a reputational backlash? It’s hard to quantify, but the widespread reluctance of skilled providers to admit patients who need medication-assisted therapy for substance use disorder is a telling sign.
Federal strategy will continue to target providers who reject without cause patients who have behavioral health needs.
There is also a shifting acknowledgement from regulators that many among us will just need help managing ADLs or other health needs while keeping behavioral conditions in check. Why can’t both needs be met in a nursing home?
With the latest dispatch from CMS, it’s becoming abundantly clear that more providers will need education on this. The time to hit the books is now.
