Behavioral Health Integration (BHI) is an effective and flexible approach to delivering behavioral health care to residents in skilled nursing, long-term care, and community settings. By connecting residents remotely with psychiatrists, therapists, care managers, and clinicians, BHI helps post-acute care providers embrace a proactive care approach that isn’t bound to the physical constraints of a facility or building.

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Integrating behavioral health care into primary care enables providers to care for residents’ comprehensive well-being. This is an undeniable component of person-centered care, supported by CMS reimbursement models, that is proven to have a positive impact on overall health and recovery for individuals in post-acute settings. 

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The Behavioral Health Challenge in Post-Acute Care

As care models in acute care have shifted, post-acute care has taken on the responsibility of caring for patients after a hospital stay, operation, or any number of complex health events. In recent years, skilled nursing facilities (SNFs) and long-term care (LTC) operators have faced several converging pressures that make it a significant challenge to dutifully care for a resident’s behavioral health needs. 

• Increasing prevalence of behavioral health conditions and mental illness among long-stay residents
• Increasing regulatory scrutiny around documentation, antipsychotic use, and gradual dose reduction (GDR)
• Limited access to psychiatric specialists, especially in rural areas

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The prevalence of residents with serious mental illness has increased by almost 80% in 15 years. (Public Policy & Aging Report)

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Coupled with operational challenges (persistent staffing constraints, fragmented coordination, and limited specialist access), nuanced changes in a resident’s behavioral health become easier to miss in this environment. 

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BHI helps address this major issue by delivering a structured, team-based, and measurable approach to behavioral health care.

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Reducing The Utilization of High-Risk Medications

One of the many benefits of BHI is its ability to stop the use of inappropriate pharmacological interventions. Properly implemented, BHI helps lower prescribing of antipsychotics, sedatives, and hypnotics, and improves documentation. Together, this not only lowers risk for residents, but also helps facilities align with regulatory requirements. 

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CMS Reporting on Antipsychotics: Changes for 2026

Beginning in 2026, CMS has updated reporting on antipsychotic use in nursing homes to better capture the frequency with which these drugs are prescribed. In response to overdiagnoses of schizophrenia, MDS data will now include all Medicare, Medicaid, and Medicare Advantage claims where an antipsychotic was prescribed. 

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This new reporting requirement will directly impact the Five-Star Quality Rating System.

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A Proactive, Team-Based Approach 

Care delivery that aims to improve an individual’s behavioral health—especially in complex care environments like skilled nursing and long-term care—requires an active approach that brings together psychiatrists, care managers, and clinicians. This team-based approach enhances oversight, collaboration, and improves coordination. 

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The BHI Framework: 

• Comprehensive review of each patient’s medical and psychiatric history
• Ongoing care planning and progress monitoring
• Documented interventions that improve survey readiness

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Improving Outcomes, Reducing Transfers, and Strengthening Stability

Behavioral health issues are a major driver of avoidable hospitalizations, ED transfers, and resident decline. BHI helps break this cycle through consistent and structured intervention.

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Facilities using integrated behavioral health models see:

• Earlier identification of psychiatric concerns
• Fewer crises that result in transfer, and better-managed crises
• Reduced hospitalizations 
• Stronger care continuity across settings
• Improved staff confidence in managing changes in resident behavior

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For residents requiring more individualized treatment, support, and oversight, Collaborative Care Management (CoCM) is a separate program from BHI that includes dedicated psychiatric consultants and care managers.

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Combined with other care management services like chronic care management and transitional care management, facilities utilizing BHI achieve a more stable care environment that reduces the potential impact of adverse health events. 

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Why BHI is a Strategic Advantage for SNFs and LTC Facilities

Beyond improving clinical outcomes, BHI delivers meaningful operational value by improving documentation practices, empowering staff with support and education, and lowering the use of high-risk medications. 

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It also provides a practical solution for facilities with limited access to behavioral specialists and strengthens person-centered care models.

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Lumina Care’s Behavioral Health Integration Program

At Lumina Care, our BHI program is led by a compassionate group of skilled clinicians who understand the unique needs of residents in skilled nursing and long-term care. Working closely with our partners in facilities across the country, our remote services become a valuable addition to their clinical capabilities. With clear communication, ongoing collaboration, and expertly managed operations, Lumina Care is the perfect addition to your team, delivering virtual clinical care to help residents improve their health. 

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