This session explores the rising prevalence of serious mental illness in long-term care and the regulatory challenges it brings. Participants will review CMS requirements for behavioral health care, focusing on psychotropic use, informed consent, gradual dose reduction, and nonpharmacological strategies. Key issues, such as misdiagnosis, inadequate documentation, and medication misuse, are addressed through real-world case studies. Attendees will gain practical tools, like behavior tracking models and care planning techniques, to navigate ethical “grey areas,” ensure compliance, and improve outcomes for residents with complex behavioral needs.

Learner Objectives:

1. Explain CMS regulations related to psychotropic medication use and chemical restraints in long-term care, including F605, F758, and F658.
2. Identify common diagnostic and documentation errors that lead to citations for schizophrenia and other serious mental illness (SMI) diagnoses.
3. Apply behavioral tracking tools and root cause analysis techniques to inform individualized, nonpharmacological care plans.
4. Demonstrate how to balance resident rights with regulatory compliance using case studies and an interdisciplinary decision-making framework.