Project 3.a.v – Behavioral Interventions Paradigm (BIP) in Nursing Homes

Why FLPPS Chose this Project

Many patients in long term care have behavioral health issues as a primary disease or as the result of other ongoing chronic diseases.  Despite the prevalence of such problems within the skilled nursing facility (SNF), staff may have inadequate formal training to manage these problems, or may rely on medication to manage these patients which often leads to unnecessary hospitalization.


Readmissions to acute care beds following admission to a SNF account
for 16% of all Medicaid readmissions.


The FLPPS region has a significantly higher prevalence of mental illness among Medicaid beneficiaries when compared to the NYS average and a higher prevalence of substance abuse disorders than the NYS average. Not only do these individuals’ behavioral health conditions influence their mental health, but these conditions also have real consequences for their physical health.


Between April 2013 and March 2014, roughly 40% of SNF patients had a behavioral health or substance abuse disorder diagnosis.


What Success Looks Like

A clear pathway to avoid patient transfers from SNF facility to an acute care hospital and better care for the SNF patient with these diagnosis.

Patient transfer interventions could include increased training for staff to identify and address behavioral health concerns.

Implementation of the BIP model in Nursing Homes using SNF-skilled nurse practitioners (NP) and psychiatric social workers to provide early assessment, reassessment, intervention, and care coordination would reduce the risk of patient crisis and transfer to a higher level of care.