B2B In‑House Therapy • Skilled Nursing & LTC Please ask about standard business services for your employees

Integrated On‑Site Mental Health Therapy for Long‑Term Care Facilities

Reduce transportation and escort costs, avoid unnecessary hospitalizations, and support CMS behavioral health standards—via a predictable monthly on‑site service model.

All businesses may contact us for standard employer services—ask about workforce support programs for your employees.

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Monthly Retainer

$5,000

On‑Site Coverage

Up to 25 hours / month

Typical Net ROI

5–6 figures*

* Based on documented NEMT/escort losses and reductions in avoidable hospitalizations (see References).

Key Statistics

$150–$300+

Typical round‑trip NEMT cost per resident (base + mileage + wait‑time).

Source: Ecolane NEMT rates

~17%

Reduction in hospital admissions using INTERACT II clinical interventions.

Source: CMS Webinar (INTERACT II)

~47% / ~49%

Fewer hospital admissions / ED visits in Evercare‑style models.

Source: CMS Webinar

~$500k / 200 beds

Annual revenue recapture potential from avoided non‑billable days.

Source: Rantz et al., 2021

Many routine transports during a Part A SNF stay are the facility’s responsibility (limited exclusions). Sources: Novitas SNF CB (Ambulance), Medicare Ambulance Booklet. Facilities must provide behavioral health care sufficient for highest practicable psychosocial well‑being: 42 CFR §483.40.

Why In‑House Therapy Matters

Embedded therapy reduces behavioral incidents, improves team coordination, and helps facilities meet psychosocial requirements for resident well‑being.

Reduce behavioral disruptions and crisis escalations ^{1, 2}
Strengthen compliance with behavioral health regulations ³
Improve resident/family satisfaction and continuity of care
Decrease staff burnout through consultation and care planning

Services Provided (On‑Site)

All services are delivered by licensed clinicians with HIPAA‑compliant documentation aligned to care plans and MDS.

Individual psychotherapy (30–60 minutes)
Grief & loss support
Behavioral health assessments
Staff consultation & behavioral care planning
Family support & caregiver communication (we do not advertise “family therapy” in Arkansas)
Employer benefit: Please ask about standard business services for your employees (workforce support & engagement)

Partnership Structure

Monthly Retainer: $5,000
On‑Site Coverage: Up to 25 hours/month (typically 1–2 days/week; scalable by census & acuity)
Predictable Budgeting: Eliminate ad‑hoc transport/escort burden for off‑site behavioral visits
Integration: Collaboration across nursing, social services, therapy, and administration

Compliance & Standards

We align with CMS expectations for behavioral health and documentation:

Fully licensed and insured clinicians
HIPAA‑compliant systems
Documentation aligned with care plans & MDS

Return on Investment (ROI)

The ROI below is grounded in published transportation rate structures and CMS‑evaluated hospitalization‑reduction models. Facility‑specific savings vary by census, acuity, mileage, transfer rates, and staffing.

Baseline Loss Drivers (Large Facilities)

Transportation (NEMT): Base ($25–$250), mileage ($3–$10/mi), wait ($15–$30/30 min) → $150–$300+ / round trip ^Ecolane
Facility Responsibility: Many routine transports during Part A stay are the facility’s responsibility (limited exclusions) ^{Novitas, Medicare booklet}
Behavioral Health Requirement: Provide necessary behavioral health services for highest practicable psychosocial well‑being ^{42 CFR §483.40}

Documented Impact of On‑Site Clinical Capacity

Avoidable Hospitalizations: INTERACT II ~17% fewer admissions; Evercare‑style ~47% fewer admissions / ~49% fewer ED visits ^{1, 2}
Revenue Recapture: ~$500,000/year per 200 beds from avoided non‑billable days ⁹

Estimated Annual Savings by Cost Area (Large Facility)

Cost Area	Conservative Estimate (Annual)	Notes
Transportation Fees	$60,000 – $120,000	NEMT usage × rate bands ^{5, 6}
Staff Time & Overtime	$25,000 – $50,000	Escorts, coverage gaps
Avoided Hospitalizations & ED Transfers	$25,000 – $50,000+	On‑site models reduce transfers ^{1, 2}
Risk & Liability Exposure	Significant (variable)	Hard costs + survey exposure

Transport Savings — Calculation Notes

Assumption: Avoid 10–20 trips/week × ~50 weeks × $150–$300+ = $75,000–$300,000+ direct transport avoidance.
Conservative display: $78,000–$312,000 ^Ecolane

Annual Investment vs. Direct Savings

Annual Investment	Conservative Transport Savings	Net Financial Impact (Transport Only)
$60,000	$78,000 – $312,000 ^{5, 6}	$18,000 – $252,000 positive

Adding hospitalization‑avoidance and revenue‑recapture typically lifts total net benefits into the six figures—especially at larger census ^{1, 2, 9}.

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Why Facilities Choose 4 Flames

Embedded therapy reduces off‑site transports and staff escorts
Material reductions in avoidable hospitalizations with on‑site clinical presence ²
Predictable monthly cost structure
Improves resident outcomes and staff morale

Contact & Next Steps

We provide virtual leadership briefings, facility walk‑throughs, and pilot options for large census operations.

Email: admin@4flamescounseling.com
Website: 4flamescounseling.com

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Employer Programs (Standard Business Services)

Support your workforce with confidential, high‑quality services that complement your HR and benefits strategy.

Program Options

EAP Liaison & Triage: Seamless referrals, warm handoffs, and coordination with your existing EAP.
Manager Consults: Guidance on difficult conversations, accommodation requests, and team dynamics.
Workshops & Trainings: Stress resilience, burnout prevention, change management, grief support, and psychological safety.
Employee Small‑Group Sessions: Confidential psychoeducational groups (non‑clinical), virtual or on‑site.
Telehealth Access: Private, HIPAA‑compliant counseling for eligible employees (private‑pay model).

Implementation & Governance

Confidentiality‑first: No PHI shared with employers; aggregate insights only.
Scope clarity: Non‑emergency services; crisis/acute risks directed to 988/911 or facility protocols.
Scheduling: Centralized contact via email; standard SLAs for response and launch timelines.
Measurement: Anonymous pulse checks, attendance, and topic interest summaries.
Brand‑safe delivery: Content tailored to your policies, tone, and workplace culture.

Discuss Employer Programs Request Workshops / Training

Note: We do not advertise family therapy in Arkansas; employer services are non‑emergency and private‑pay.