Synergy in Basic and Applied BSSR

Systematic Integrated Health Care Initiative Applied Behavioral Analysis Access for Dementia Care

Skilled Nursing Facilities are positioned to fill more and more critical roles as our expected longevity increases. Within SNF care and challenges, one of the greatest is humanely addressing patient behavioral disturbances without the use of chemical restraints, like antipsychotic medications. Examples would include Dementia residents who repetitively call out, become fearful or combative during bathing, residents who are steadily losing ADL or SCS such as feeding or toileting, or even those hovering near doors and presenting wandering/elopement risks. An effective mode of resident treatment or even medical staff case consultation may originate in Psychology and Applied Behavioral Analysis (ABA) or Functional Assessment, which at this time is not widely available (or even reimbursed) for this diagnostic group. Psychological interventions/therapy with dementia patients is not supported by CMS reimbursement, as patient memory for interventions can't succeed. But the facility can learn as the patient's proxy in this regard how to achieve or preserve their functioning via psychological intervention. The patient could benefit from the patient-centered consultation specifically designed for them At a systems level, these consultants could help SNFs approach a general problem (for example, how do you help stroke patients with fastest skill recovery?). This model does not fall easily along insurance or CPT code definitions at this time, but it is no less meaningful. It is submitted for consideration.

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Idea No. 288