OBRA Assessment & Treatment

Every Community Mental Health (CMH) receives money from the State of Michigan to provide mental health services in nursing facilities. The type and frequency of services are determined by the resident’s diagnosis and level of need. The decision to accept services is made by the resident or their guardian. There may be a charge for some types of treatments.

The local CMH is one potential provider of mental health services. Other agencies, the facility staff or private practitioners may also provide mental health services in the nursing home.

Mental health treatment is intended to enhance and compliment services being provided by the nursing facility, aiding in the resident’s recovery.

Questions may be directed to the Northern Lakes OBRA Coordinator at (231) 935-4181

OBRA Screening

Anyone seeking admission to a nursing facility must be screened for indicators of an Intellectual/Developmental Disability or a mental illness, prior to admission. Residents already in a nursing facility must be screened annually and/or for significant changes in their condition. This is called a Level I screening. If indicated, a multi-disciplinary assessment (Level II) must be completed to identify best care setting and make mental health treatment recommendations.

OBRA Assessment

There is no charge for the OBRA assessment (Level II). The assessment team will come to the resident’s location. The team will include a nurse and a social worker. Other disciplines are included based on the indicators on the Level I screening form.

The team will interview the resident, the medical staff, review medical records and, if allowed, talk with family. The team is looking for information to determine if there is a mental health diagnosis. They may also suggest treatment and treatment providers. The team will make a recommendation on the type of care setting, which will allow the resident to attain their highest level of health and wellbeing. Nursing care is one possible setting. The resident’s wishes and goals play a significant role in this process.

Role of the State

The Michigan Department of Health and Human Services (MDHHS/ State) contracts with each area Community Mental Health (CMH) to provide the evaluation known as the Level II Evaluation. Based on the Level II Evaluation, the State makes a decision whether the resident is admitted to or allowed to remain in nursing care. The nursing facility must follow this decision and recommendations. This decision will also indicate a level of mental health services, which the resident may choose to receive.

The State sends its decision back to the CMH, and the CMH in turn meets with the resident to explain the results, as well as the appeal process. These findings are also shared with the nursing facility and the resident’s physician. If the resident does not agree with the results from MDHHS, they may appeal, using appeal forms which are included with their copy of the assessment.