You Can’t Have Mental Health Services – You’re on Medicare!

Something interesting I’m finding in many facilities, and let me tell you, I’m a little upset over it.  Apparently, there are nursing home administrators out there that are telling their facilities that no resident can have mental health services while they’re on Medicare Part A.  What?  This is a terrible management decision.  If your administrator or your company is doing this, tell them I’m taking their keys right now.  They shouldn’t even worry about coming in tomorrow.  Or give them a link to this website.

As I explained in the 5 C’s of Long Term Care, Care always comes first.  The simple reason that the decision was made not to provide mental health services to residents on Part A is that the facility would be required to pay for the services.  It’s carved out of the Part A RUG rate the facility receives.

Ok, so the facility pays for it…so what?  Let’s consider what happens if you don’t provide the needed mental health/psyche services for your resident.  Not only will you be out of compliance, you are potentially allowing the resident’s condition to worsen to a point where they may harm another resident if the appropriate interventions and medication adjustments are not performed, which is part of what you should be receiving from your contracted mental health provider.  Then, what are you looking at?  Lawsuits.  G-tags or even an IJ.  All because someone wanted to save money.

Here’s a hint to those penny-pinching administrators who don’t come out of their office.  Instead of trying to save money by withholding services necessary for a resident, why don’t you focus on taking better care of your residents, promoting your facility, and increasing your revenue that way.

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