| February 2025 Newsletter The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) provides mental health and substance use evidence-based training, customized technical assistance, and resources to certified Medicare and Medicaid nursing facilities that care for residents with a variety of behavioral health conditions at absolutely no cost. To submit a request for assistance, complete the online request form by clicking HERE. | | | | The COE-NF created several in-service toolkits to provide nursing facility staff with guidance on how to deliver high-quality behavioral health training, whether they work directly or indirectly with residents. Helping nursing facility staff increase their behavioral health knowledge is essential for improving resident care. Behavioral health training equips staff with the skills to manage complex behavioral needs effectively and safely, boosts confidence in working with residents with behavioral health disorders and assists with meeting training requirements. According to §483.40, a facility must provide behavioral health training consistent with the facility assessment at §483.70(e). | |
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| Join the COE-NF Team for a webinar on how to use the in-service toolkits in nursing facilities to
increase your team's skills and confidence in providing behavioral health care. | | |
| The COE-NF is excited to announce the Spring 2025 series of the Behavioral Health Action
Network, a cohort learning collaborative. This three-part series of virtual one-hour sessions kicks off in March and offers continuing education credits. CMS-certified nursing facilities across the United States are invited to join us for these interactive sessions. | | | |
Participants will:
- Learn from experts and peers: Gain valuable insights from subject matter experts and peers from nursing facilities nationwide.
- Improve resident care: Enhance your care planning processes, communication skills, and learn de-escalation strategies to support residents with serious mental illness and substance use disorders.
- Apply learnings: Receive support from the BHAN education team and your regional behavioral specialist to implement strategies
directly in your facility.
The series is designed to meet the needs of leadership and interdisciplinary staff members and facilitate better resident outcomes. | | | | The COE-NF is committed to providing essential behavioral health support to help nursing facilities across the United States and its territories at no cost. Our engagement efforts with CMS-certified nursing facilities include a variety of trainings, individualized consultations, resources, and more, all aimed at improving behavioral health outcomes. By enhancing the education and competence of nursing facility staff, we're equipping them to better meet the behavioral health needs of their residents. | | |
| | We invite all nursing facilities to actively participate in these efforts to improve behavioral health care. Check out our infographic and learn more about how these initiatives are making a positive impact. Together, we can create healthier and more supportive
environments for residents. | | |
| Nursing Facility Guidance: Strengthening Oversight of Psychotropic Medication Use | | |
| On November 18, 2024, CMS issued significant revisions to enhance the quality and
oversight of the LTC survey process. This guidance for nursing home surveyors includes information regarding the unnecessary use of psychotropic medications. Surveyors will begin using this guidance to determine compliance with requirements on surveys beginning March 24, 2025. | | | Key provisions regarding psychotropic medications include: - The section on unnecessary psychotropic medications has been removed from F758
Unnecessary Medications and included in the F605 Chemical Restraints/Unnecessary Psychotropic Medications.
- The guidance regarding “convenience” has been updated to include situations where medications are used to induce sedation symptoms or minimize the effort required from facility staff to address residents’ needs.
- Additional guidance emphasizes the importance of residents' rights to be fully informed about their treatment and to participate in decisions regarding their care, including the right to accept or refuse medication. Before starting or increasing psychotropic medication, facilities must notify
residents and ensure they can engage in their treatment decisions.
- This requirement intends for each resident to attain and maintain his/her highest practicable well-being in an environment that prohibits the use of chemical restraints for discipline or convenience. If a medication has a sedating or subduing effect on a resident and is not being administered to treat a medical symptom, the medication is acting as a chemical restraint.
- When a medication is indicated to treat a medical symptom, the facility must use the least restrictive alternative for the shortest duration possible. Additionally, there should be an
ongoing re-evaluation of the need for the medication, and it must not be used for disciplinary purposes or convenience.
- The Unnecessary Medications (F758) section has been revised to focus solely on non-psychotropic medications. Furthermore, the updated Critical Element Pathway for Unnecessary Medications, Chemical Restraints/Psychotropic Medications, and Medication Regimen Review now includes investigative elements that align with the revised guidance.
What can you do TODAY?
Access the training module available on CMS’s Quality, Safety & Education Portal (QSEP) outlining the changes to the Long-Term Care Appendix PP Regulatory and Interpretive Guidance Updates – Effective March 2025. The course consists of three presentations by the Division of Nursing Homes related to Admission, Transfer, and Discharge, Pain Management, Chemical Restraints/Unnecessary Psychotropic Medications, Accuracy of Assessment, and Professional Standards.
View the COE-NF training recordings on Practical Strategies for Managing Behavioral Health Needs of Nursing Home Residents and An Easy Pill to Swallow: Nonpharmacological Interventions for Long-Term Care Residents to help understand person-centered care principles for addressing challenging behaviors and implementing nonpharmacological interventions.
Use the Schizophrenia in Nursing Facilities: Validating Diagnosis and Planning for Appropriate Care to help validate the accuracy of a schizophrenia diagnosis and use ideas from the Comfort Menu to identify individualized nonpharmacological interventions. | | | | The COE-NF stands ready to support your facility in these guidance areas. Contact us today: | | | | COE-NF In-Action
Consultation Summary: Enhancing Opioid Preparedness and Response | | | The COE-NF In-Action consultation summaries
demonstrate how the COE-NF provides critical mental health and substance use support to nursing facilities. The summaries include ideas and ways to transform your nursing facility’s approach to providing high-quality behavioral health care to residents.
In this issue, the COE-NF is spotlighting the following summary:
Enhancing Opioid Overdose Preparedness and Response: Training and Resources for Nursing Facility Staff
After a resident in a nursing facility serving veterans experienced an opioid overdose, it highlighted a need for staff training regarding overdose response and naloxone use. In response, the Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) partnered with the facility to improve education and resources focused on overdose readiness and response techniques. This partnership involved conducting training
sessions for staff, creating easily accessible naloxone reference guides, and advising on tailored storage solutions for the medication. | | | | Have mental illness and substance use questions? We have the answers! Join us for office hours to talk with the
experts. | | | Managing Substance Use Disorders in Nursing Facilities
Interested in receiving expert answers to substance use challenges you are facing in your nursing facility? Join Dr. Jen Azen and Dr. Swati Gaur, subject matter experts, as they answer questions related to your complex cases. No question is too big or too small!
Join our monthly office hours on
the third Friday of each month from 1-1:30 p.m. ET to get answers directly from the experts working in nursing facilities!
Audience: Appropriate for clinicians, nurses, administrators, and social workers. | | | | CARES® Serious Mental Illness™
The COE-NF is making the CARES® Serious Mental Illness™ Online Training Program available to CMS-certified nursing facilities at no cost. CARES® Serious Mental Illness™ focuses on how to
develop care strategies for individuals diagnosed with a Serious Mental Illness (SMI) and how SMI differs from dementia.
Interested in learning more about CARES® Serious Mental Illness™ before committing, or have general questions about the program?
Join our monthly office hours meeting on the fourth Wednesday of each month from 2:30-3 p.m. ET for an open discussion on implementation, benefits, case studies and successes.
Audience: Appropriate for staff at all levels of care | | | | The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) has developed a range of resources designed to educate nursing facility teams. | | | | | De-Escalation Strategies In-Service Toolkit
The techniques in the de-escalation toolkit can be used in any situation to diffuse tension, promote understanding, and prevent further escalation. An English and Spanish version of the resource is available for download. Download the De-Escalation Strategies In-Service Toolkit | | | | | Major Depressive Disorder In-Service Toolkit
The major depressive disorder (MDD) toolkit is used to educate nursing facility staff about MDD, including its risk factors and symptoms, as well as the appropriate steps to take when supporting a resident with MDD. Download the Major Depressive Disorder In-Service Toolkit |
| | | | Substance Use
Disorder In-Service Toolkit
The substance use disorder (SUD) toolkit is used to equip staff with knowledge and skills related to the disease concept of substance use, the impact substances have on brain chemicals, and the appropriate steps to take when supporting residents with SUD. Download the Substance Use Disorder In-Service Toolkit | |
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Interested in accessing additional COE-NF resources for your facility?
| | | | | Did you know that you can integrate behavioral health into your Quality Assurance Performance Improvement (QAPI) initiatives?
Connect with a behavioral specialist to develop a tailored plan to improve behavioral health outcomes within your facility. | | | |
February is packed with opportunities for professional growth and learning! These virtual sessions are led by expert instructors and offer actionable strategies to enhance care, along with valuable ACCME and NAB credits. Don’t miss this chance to elevate your skills and make a lasting impact in your field.
Secure your spot today - space is limited! | | |
Mental Health 101 and
Suicide Prevention | | |
| Wednesday, February 19, 2025
2-3 p.m. ET
1.0 ACCME & 1.0 NAB credits will be offered.
This session is an introductory training to help identify, understand, and respond to signs of mental health disorders. Join us as we address some of the common causes contributing to the onset or exacerbation of mental health symptoms among nursing home residents and share common warning signs and practical strategies on how staff can support improving
resident mental wellness. Participants will also gain helpful strategies for suicide prevention.
Learning objectives: - Define and discuss common mental health disorders in nursing facilities.
- Discuss causes contributing to the onset or exacerbation of symptoms.
- Provide awareness of suicide prevention and helpful strategies
to assist residents.
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Mental Health First Aid (MHFA) | | | | **Registration Closed: This session is now
full** | | | | Thursday, February 20, 2025
11 a.m.-4:30 p.m. ET
7.75 NAB credits and 5.5 ACCME credits will be offered after completing the live training.
Mental Health First Aid (MHFA) training provides skills to engage and provide initial help and support to someone developing a mental health or substance use challenge or experiencing a crisis.
This session provides a MHFA certification for three years.
The training covers: - Common signs and symptoms of mental health and substance use challenges.
- How to interact with a person in crisis.
- How to connect a person with help.
- Expanded content on trauma, substance use and self-care.
The training is divided into three parts:
Part 1 starts AFTER initial registration has been APPROVED by the instructor. Approved registrants will be emailed instructions on how to create an online profile using MHFA Connect and complete a pre-survey/quiz followed by a two-hour self-paced online course. Registrants MUST complete Part 1 no less than 48 hours (two business days) prior to the scheduled Part 2 session.
Part 2
is a 5.5-hour live instructor-led virtual training. Participants are required to be on camera the entire time.
Part 3 participants will return to MHFA Connect to complete the post-test and evaluation, which is required to receive a certificate of participation. | | | Utilizing In-Service Toolkits to Expand Behavioral Health Capacity |
| | | Tuesday, February 25 2025
2-3 p.m. ET 1.0 ACCME & 1.0 NAB credits will
be offered.
Join the Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) team as they showcase their new in-service toolkits and demonstrate how to use them effectively to enhance team training in nursing facilities. These toolkits address essential topics such as de-escalation, substance use disorder, and major depressive disorder. Designed to guide facility education leads, the toolkits provide comprehensive support for every step of the training process, from scheduling and promoting to hosting and facilitating behavioral health education sessions.
Learning objectives:
- Discover how a multipronged training approach promotes engagement, increases competency, and reinforces different learning styles.
- Learn the purpose and key features of the COE-NF In-service toolkits.
- Understand how to utilize these innovative toolkits to simplify the behavioral health training process.
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| Mental Health First Aid (MHFA) | | |
| **Registration Closed: This session is now full** | | | | Friday, February
28, 2025
11 a.m.-4:30 p.m. ET
7.75 NAB credits and 5.5 ACCME credits will be offered after completing the live training.
Mental Health First Aid (MHFA) training provides skills to engage and provide initial help and support to someone developing a mental health or substance use challenge or experiencing a crisis.
This session provides a MHFA certification for three years.
The training covers: - Common signs and symptoms of mental health and substance use challenges.
- How to interact with a person in crisis.
- How to connect a person with help.
- Expanded content on trauma, substance use and self-care.
The training is divided into three parts:
Part 1 starts AFTER initial registration has been APPROVED by the instructor. Approved registrants will be emailed instructions on how to
create an online profile using MHFA Connect and complete a pre-survey/quiz followed by a two-hour self-paced online course. Registrants MUST complete Part 1 no less than 48 hours (two business days) prior to the scheduled Part 2 session.
Part 2 is a 5.5-hour live instructor-led virtual training. Participants are required to be on camera the entire time.
Part 3 participants will return to MHFA Connect to complete the post-test and evaluation, which is required to receive a certificate of participation. | | |
| Working in a high-stress environment requires a high level of resilience. Just like building a muscle, increasing your resilience takes time, effort, and intentionality. By focusing on four core components—connection, wellness, healthy thinking, and meaning—you can develop the strength to manage stress effectively and thrive in challenging situations. | | | | | | Join our text message list!
Scan the QR code or click the button below to sign up and receive text notifications from COE-NF.
Stay up-to-date on COE-NF news and events. | | | | | | |
Contact us:
For more information, please call 1-844-314-1433 or email coeinfo@allianthealth.org.
To submit a request to inquire about substance use and/or mental health training options for your facility, complete the inquiry form.
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| | | Alliant Health Solutions (AHS) was awarded a three-year cooperative agreement from the Substance Abuse and Mental
Health Services Administration (SAMHSA), in collaboration with the Centers for Medicare & Medicaid Services (CMS), to create the COE-NF. AHS has over 50 years of experience working with nursing facilities and behavioral health in nursing facilities.
| | | | | This newsletter was made possible by grant number 1H79SM087155 from the Substance Abuse and Mental Health Services Administration (SAMHSA). Its contents are
solely the responsibility of the authors and do not necessarily represent the official views of the Substance Abuse and Mental Health Services Administration. | | | |
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