Acute Care, Skilled Nursing Facility, Assisted Living Facility

skilled3_banner

Neuropsychological Services

What are the kinds of symptoms that might lead someone to receive a referral for neuropsychological assessment?

Our evaluations can address a variety of questions and concerns. Examples of questions we regularly address include:

  • Is this person experiencing problems with memory? If so, how severe are they?
  • Could depression be interfering with this person's thinking skills?
  • This person is experiencing numerous symptoms. What is the diagnosis that best explains why this person is behaving in a particular way?
  • This patient has a number of medical conditions. Are those conditions affecting the way this person thinks and feels?
  • Why does this person have trouble multi-tasking?
  • Can this person make decisions regarding their estate? Financial care? Medical care?

What are some of the questions that neuropsychological assessment can address?

Neuropsychological assessment can be used for the following diagnostic purposes:

  • Diagnosing the nature and severity of disorders in which cognition is affected, such as Alzheimer's Disease, Vascular Dementia, traumatic brain injury, cardiovascular conditions, and stroke
  • Differential diagnosis (e.g., depression versus dementia)
  • Determination of functional outcomes, such as whether individuals have capacity to make various types of decisions, whether they can live independently, or whether they can drive
  • Provides realistic picture of strengths and weaknesses

Are there medical disorders that may cause neuropsychological impairment?

Medical disorders that may cause NP impairment:

  • alcoholism
  • cardiovascular disease
  • congestive heart failure
  • COPD
  • drug addiction
  • hypertension
  • hypothyroidism
  • Major Depressive Disorder
  • multiple sclerosis
  • obstructive sleep apnea
  • Parkinson’s disease
  • psychiatric/psychological disorders
  • PTSD
  • sleep disorders
  • traumatic brain injury
  • vitamin B12 and folate deficiencies

How long will the evaluation take?

Neuropsychological assessment involves the administration of paper-and-pencil tests to evaluate various cognitive functions, such as attention, language, speed of information processing, frontal lobe functioning, and personality/emotional functioning. Moreover, it includes a clinical interview, the completion of a history form, and a collateral interview. For older individuals in an assisted living facility, hospital setting, skilled nursing facility setting, the procedure lasts around 30—120 minutes.

Follow-up evaluations

After the initial evaluation, follow-up appointments will be scheduled on an as-needed basis. The purpose of the follow-up appointments may include, but is not limited to, determining the efficacy of treatment, adjusting the medication regimen, and/or a revision of treatment goals. The treatment plan may consist of recommendations for medication management, psychotherapy, further psychodiagnostic assessment, or any combination of the preceding. A typical follow up is scheduled 9 to 12 months after the original evaluation; however, for patients undergoing acute rehabilitation or for patients experiencing an acute change in cognition, emotion, or behavior, the follow-up evaluation is likely to occur sooner.

What will you receive upon completion of a neuropsychological assessment?

Subsequent to the completion of the neuropsychological evaluation, a facility will receive the following documentation:

  • A one to two page executive summary that includes the differential diagnosis, identification of cognitive and psychological/psychiatric disorders, and treatment recommendations
  • A seven to nine page report that includes a comprehensive review of the resident’s medical and mental health history, a detailed discussion of the test results, a differential diagnosis, identification of cognitive and psychological/psychiatric disorders, and treatment recommendations
  • Identification of patients of who can benefit from psychotherapeutic/behavioral interventions

It is important to note that, at the time that the testing is complete, the doctor will typically place a comprehensive, handwritten chart note that provides a preliminary discussion of the test results. This approach ensures that the procedure is immediately documented in the chart.

Can we help you improve your survey process?

  • At the time of admission, we work in tandem with the primary care physicians, psychiatrists, and facility staff at the time of admission to:
    • Provide a differential diagnosis.
    • Assist in the formulation of a long-term plan of care.
    • Identify specific psychosocial needs.
  • During the course of the resident’s stay, Executive Mental Health can provide psychological services that are helpful in the following ways:
    • Work with the resident to help them manage their depression and anxiety and to adjust to a new environment.
    • Assist in the reduction of the use of psychotropic, when feasible
    • Reduce the severity of mental health symptoms through ongoing psychological care.
    • Enable residents to develop coping skills to manage their symptoms.
    • Assist the resident and/or family members in terms of coping with significant medical illness and/or end-of-life issues
  • We provide state-of-the-art documentation of services to demonstrate that facilities are:
    • Aware of residents’ mental state diagnoses
    • Proactively addressing these conditions and future needs
  • The reports can be used to complete the MDS by:
    • Clarifying Mood and Behavior (Sections C, D, and E)
    • Providing a framework to develop an individualized care plan and goals for the treatment of the identified mood and behavior conditions.
    • Determining the best approach for discharge planning, such as the location that is best equipped to manage a patient’s current medical and psychosocial needs (Section Q)
    • Enabling the staff to provide details regarding the Problem/Approach/Goal for addressing mental health conditions (Section V)
  • During survey, the clinicians at your facility can be available to answer surveyors’ questions

Cost to the facility

Executive Mental Health contracts with Medicare – Part B and Medi-cal. We are independent contractors, bill direct to the carrier, and do not bill the facility for services unless the facility specifically requests services for a private pay client.


Psychological Services

What are some of the reasons that might lead someone to receive a referral for psychological services?

  • To demonstrate that the facility is utilizing non-pharmacological interventions to treat mental health disorders, such as depression and anxiety.
  • Reduce facility costs by minimizing and/or eliminating the need for psychotropic medications, such as antidepressants, anxiety medications, and/or sleep medications.
  • To treat symptoms of depression and anxiety in place of medication or with medication to reduce symptoms of depression or anxiety.
  • To assist a patient in terms of adjusting to changes in their living situation, such as moving from their home to an assisted living facility or skilled nursing facility.
  • To assist the family members of a patient so that the family members understand the nature of the patient’s medical and/or mental health conditions.
  • Can this person make decision regarding their finances? Their estate? Their medical care?

How does the psychotherapy process work?

  • The first contact involves an initial interview and the assessment of psychological symptoms, such as depression and anxiety and mental capacity, using industry standard measures.  By measuring these symptoms, we establish a baseline that allows to determine the effectiveness of ongoing treatment
  • Treatment sessions last from 16 minutes to 60 minutes, depending on the patient’s needs and the issues to be addressed.
  • Every 4 to 8 weeks, follow-up assessments are conducted to re-evaluate the patient status, compare the severity of their current symptoms to the baseline severity from the initial evaluation, and to determine the effectiveness of ongoing treatment.
  • Psychological services may be provided up to 2 to 3 times per week, depending on the needs of the patient and the issues to be addressed.
  • As the psychological symptoms improve, the frequency of treatment will decrease.
  • Once symptoms have resolved to a sufficient levels and the patient needs are addressed, the necessity of ongoing treatment will be re-evaluated.

Can we help you improve your survey process?

  • At the time of admission, we work in tandem with the primary care physicians, psychiatrists, and facility staff at the time of admission to:
    • Provide a differential diagnosis.
    • Assist in the formulation of a long-term plan of care.
    • Identify specific psychosocial needs.
  • During the course of the resident’s stay, Executive Mental Health can provide psychological services that are helpful in the following ways:
    • Work with the resident to help them manage their depression and anxiety and to adjust to a new environment.
    • Assist in the reduction of the use of psychotropic, when feasible
    • Reduce the severity of mental health symptoms through ongoing psychological care.
    • Enable residents to develop coping skills to manage their symptoms.
    • Assist the resident and/or family members in terms of coping with significant medical illness and/or end-of-life issues
  • We provide state-of-the-art documentation of services to demonstrate that facilities are:
    • Aware of residents’ mental state diagnoses
    • Proactively addressing these conditions and future needs
  • The reports can be used to complete the MDS by:
    • Clarifying Mood and Behavior (Sections C, D, and E)
    • Providing a framework to develop an individualized care plan and goals for the treatment of the identified mood and behavior conditions.
    • Determining the best approach for discharge planning, such as the location that is best equipped to manage a patient’s current medical and psychosocial needs (Section Q)
    • Enabling the staff to provide details regarding the Problem/Approach/Goal for addressing mental health conditions (Section V)
  • During survey, the clinicians at your facility can be available to answer surveyors’ questions

Cost to the facility

Executive Mental Health contracts with Medicare – Part B and Medi-cal.  We are independent contractors, bill direct to the carrier, and do not bill the facility for services unless the facility specifically requests services for a private pay client.

back