Name of the Procedure:

Common name(s): Long-term Residential Behavioral Health Care
Technical or medical term: HCPCS T2048 - Behavioral health; long-term care residential (non-acute care in a residential treatment program with room and board, per diem)

Summary

Long-term residential behavioral health care provides comprehensive support for individuals needing extended treatment for mental health or substance use disorders. This non-acute care is typically provided in a residential setting for stays longer than 30 days and includes room and board.

Purpose

Medical Conditions:

• Chronic mental health disorders (e.g., schizophrenia, bipolar disorder)
• Substance use disorders (e.g., alcohol or drug addiction)
• Severe depression or anxiety requiring extended care

Goals:

• Stabilization of mental health conditions
• Comprehensive treatment and rehabilitation
• Skill-building for independent living
• Relapse prevention and consistent support

Indications

Symptoms or Conditions:

• Persistent psychological distress not manageable with outpatient services
• Repeated relapse in substance use despite previous treatments
• Lack of a supportive home environment
• Chronic or severe mental health issues

Patient Criteria:

• Individuals aged 18 or older with a documented mental health or substance use disorder
• Patients requiring a structured and supportive living environment
• Those who benefit from extended monitoring and support

Preparation

Instructions:

• Comprehensive psychiatric and medical evaluations before admission
• Screening for physical health conditions that may require attention
• Review and potential adjustment of current medications
• Packing personal items for a stay of over 30 days, including comfortable clothing and personal hygiene items

Procedure Description

Steps:

1. Admission and Assessment: Initial comprehensive assessment by a care team (psychiatrists, psychologists, and social workers) to develop an individualized treatment plan.
2. Individual Therapy: Regular one-on-one sessions focused on addressing personal psychological challenges.
3. Group Therapy: Group sessions to build social skills, share experiences, and receive peer support.
4. Medication Management: Ongoing evaluation and adjustment of psychiatric medications as needed.
5. Skill-building Activities: Daily activities to encourage social, vocational, and daily living skills.
6. Recreational Therapy: Structured recreational activities to promote physical well-being and reduce stress.
7. Family Therapy: Sessions with family members to improve communication and support systems.

Tools and Equipment:

• Therapy rooms and equipment for various types of counseling and activities
• Medical equipment for monitoring physical health
• Secure storage for medications

Anesthesia or Sedation:

Not applicable

Duration

Stays typically last longer than 30 days and can vary based on individual needs, often ranging from several months to a year.

Setting

Residential treatment facilities offering a structured, non-acute care living environment.

Personnel

• Psychiatrists
• Psychologists
• Licensed Professional Counselors
• Social Workers
• Nurses
• Residential staff providing daily living support

Risks and Complications

Common Risks:

• Adjustment challenges to the residential setting
• Initial increase in anxiety or stress due to new environment

Rare Risks:

• Adverse reactions to new medications
• Possible physical health issues due to prolonged inactivity

Management:

• Ongoing risk assessments and individualized care plans
• Prompt medical intervention for any complications

Benefits

Expected Benefits:

• Stabilization of mental health conditions
• Development of coping strategies and life skills
• Reduced risk of relapse and hospital readmission
• Improved overall quality of life

Timeline:

Benefits typically begin to manifest within a few weeks to a few months, depending on individual progress.

Recovery

Post-Procedure Care:

• Continuous support through outpatient services or follow-up residential care
• Transition planning for a return to independent or supported living arrangements

Recovery Time:

Varies; some individuals may require several months or longer for complete stabilization and independence.

Restrictions and Follow-up:

• Ongoing outpatient therapy and psychiatric follow-up
• Continued participation in support groups and community resources

Alternatives

Other Treatment Options:

• Outpatient therapy and medication management
• Partial hospitalization programs
• Intensive outpatient programs
• Short-term residential treatment

Pros and Cons:

• Outpatient Therapy: Less intensive, allows living at home, but may not provide enough support for severe cases.
• Partial Hospitalization: More structured than outpatient, provides a higher level of support but does not include overnight stay.
• Intensive Outpatient Programs: High level of support while allowing patients to return home each day, yet may still lack the 24/7 supervision some patients need.

Patient Experience

During the Procedure:

• Patients experience structured daily routines, which might include therapy sessions, group activities, and recreational time.
• Initial period of adjustment to the new setting and schedule.
• Continuous availability of support staff for assistance and guidance.

Pain Management and Comfort Measures:

• Emotional support through therapy sessions and peer groups.
• Comfortable living accommodations designed to provide a homely environment.