This letter from CMS explains the requirements for providing behavioral health services in nursing homes and other healthcare facilities. It defines terms related to behavioral health care, such as "highest practicable physical, mental, and psychosocial well-being" and "substance use disorder". It also provides guidance on how to approach providing behavioral health care, including through an interdisciplinary approach and individualized assessments and care plans. Facilities must also ensure that pharmacological interventions are only used when non-pharmacological interventions are ineffective or clinically indicated. Additionally, facilities must provide meaningful activities that address the resident's needs, and must screen residents for mental disorders and substance use disorders prior to admission. Finally, behavioral contracts may be used to address behaviors that could endanger the resident or others, but must not conflict with resident rights or other requirements of participation. Nursing homes and healthcare facilities must take these requirements into account when providing behavioral health services to ensure that the highest practicable physical, mental, and psychosocial well-being of each resident is attained or maintained.

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