Providing behavioral health care and services is an integral part of the person-centered environment. This involves an interdisciplinary approach to care, with qualified staff that demonstrate the competencies and skills necessary to provide appropriate services to the resident. Individualized approaches to care (including direct care and activities) are provided as part of a supportive physical, mental, and psychosocial environment, and are directed toward understanding, preventing, relieving, and/or accommodating a resident’s distress or loss of abilities. Each resident must receive and the skilled nursing facility must provide the necessary behavioral health care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care. Behavioral health encompasses a resident’s whole emotional and mental well-being, which includes, but is not limited to, the prevention and treatment of mental and substance use disorders (§483.40).
Regulations for skilled nursing are changing again in 2019. This implementation is the last of a 3-phase execution of new regulations which began in November 2017. This year, November 2019, will introduce survey review and compliance training requirements for various focused subjects. In late 2017, Federal officials put eight areas of fines on hold. Targeted areas include smoking policies, antibiotic stewardships and behavioral health services. Centers for Medicare & Medicaid Services (CMS) instituted the moratorium for enforcement penalties under Phase 2 of the Final Rules of participation in 2017 to give SNFs more time to educate employees. F-Tags specifically associated with behavioral health included; access to care for behavioral health services (F741) and psychotropic medications related to PRN limitations (F758).