Mental health in our senior population

Often, our senior population faces problems that we cannot see in the form of mental illness. Stressors such as chronic pain, reduced mobility, loss of a spouse and a decrease in functional ability can lead to- isolation, loneliness or other psychological distress. While we may not be able to see these conditions with our naked eye it is important to recognize and address it head on in the form of training our staff to provide care for those with mental health disorders and developing senior-focused services and settings that are geared toward those conditions. The state of Virginia has mandated a mental health screening for certain individuals prior to their admission into the community. For more information take a look below:

22VAC40-73-330. Mental health screening.

  • A mental health screening shall be conducted prior to admission if behaviors or patterns of behavior occurred within the previous six months that were indicative of mental illness, intellectual disability, substance abuse, or behavioral disorders and that caused, or continue to cause, concern for the health, safety, or welfare either of that individual or others who could be placed at risk of harm by that individual.

EXCEPTIONS:

  1. If it is not possible for the screening to be conducted prior to admission, the individual may be admitted if all other admission requirements are met. The reason for the delay shall be documented and the screening shall be conducted as soon as possible, but no later than 30 days after admission.
  2. The screening shall not be required for individuals under the care of a qualified mental health professional immediately prior to admission, as long as there is documentation of the person’s psychosocial and behavioral functioning as specified in 22VAC40-73-340 A 1.
  3. A mental health screening shall be conducted when a resident displays behaviors or patterns of behavior indicative of mental illness, intellectual disability, substance abuse, or behavioral disorders that cause concern for the health, safety, or welfare of either that resident or others who could be placed at risk of harm by the resident.
  4. The mental health screening shall be conducted by a qualified mental health professional having no financial interest in the assisted living facility, directly or indirectly as an owner, officer, employee, or as an independent contractor with the facility.
  5. A copy of the screening shall be filed in the resident’s record.
  6. If the screening indicates a need for mental health, intellectual disability, substance abuse, or behavioral disorder services for the resident, the facility shall provide:
  7. Notification of the resident’s need for such services to the community services board, behavioral health authority, or other appropriate licensed provider identified by the resident or his legal representative; and
  8. Notification to the resident, authorized contact person of record, and physician of record that mental health services have been recommended for the resident.

22VAC40-73-340. Psychosocial and behavioral history.

  1. When determining appropriateness of admission for an individual with mental illness, intellectual disability, substance abuse, or behavioral disorders, the following information shall be obtained by the facility:
  2. If the prospective resident is referred by a state or private hospital, community services board, behavioral health authority, or long-term care facility, documentation of the individual’s psychosocial and behavioral functioning shall be acquired prior to admission.
  3. If the prospective resident is coming from a private residence, information about the individual’s psychosocial and behavioral functioning shall be gathered from primary sources, such as family members, friends, or physician. Although there is no requirement for written information from primary sources, the facility must document the source and content of the information that was obtained.
  4. The administrator or his designee shall document that the individual’s psychosocial and behavioral history were reviewed and used to help determine the appropriateness of the admission.
  5. If the individual is admitted, the psychosocial and behavioral history shall be used in the development of the person’s individualized service plan and documentation of the history shall be filed in the resident’s record.

22VAC40-73-350. Sex offender information.

  1. The assisted living facility shall register with the Department of State Police to receive notice of the registration or reregistration of any sex offender within the same or a contiguous zip code area in which the facility is located, pursuant to § 9.1-914 of the Code of Virginia.
  2. The assisted living facility shall ascertain, prior to admission, whether a potential resident is a registered sex offender if the facility anticipates the potential resident will have a length of stay greater than three days or in fact stays longer than three days and shall document in the resident’s record that this was ascertained and the date the information was obtained.
  3. The assisted living facility shall ensure that each resident or his legal representative is fully informed, prior to or at the time of admission and annually, that he should exercise whatever due diligence he deems necessary with respect to information on any sex offenders registered pursuant to Chapter 9 (§ 9.1-900 et. seq.) of Title 9.1 of the Code of Virginia, including how to obtain such information. Written acknowledgment of having been so informed shall be provided by the resident or his legal representative and shall be maintained in the resident’s record.
  4. At the same time that the person is informed as required in subsection C of this section, the assisted living facility shall provide notification that, upon request, the facility shall:
  5. Assist the resident, prospective resident, or his legal representative in accessing the information on registered sex offenders; and
  6. Provide the resident, prospective resident, or his legal representative with printed copies of the information on registered sex offenders.

Top Takeaways:

  • A mental health screening shall be conducted prior to admission if behaviors or patterns of behavior occurred within the previous six months that were indicative of mental illness, intellectual disability, substance abuse, or behavioral disorders and that caused, or continue to cause, concern for the health, safety, or welfare either of that individual or others who could be placed at risk of harm by that individual.

This is where the preadmission assessment and interview are so important. If you do not perform an effective fact-finding interview and get the fact and history of the resident, you will not be aware of any potential mental health issues which would trigger a mental health screening.

  • If the screening indicates a need for mental health, intellectual disability, substance abuse, or behavioral disorder services for the resident, the facility shall provide:

The mental health screening cannot just be performed and stowed away in the residents file. If the resident is deemed to have a need for mental health services you must do your due diligence to get the resident the services they need.