This article is sponsored by TeamHealth. In this Voices interview, Skilled Nursing News sits down with Jessica Stone, Regional Clinical Director of Post-Acute Care Behavioral Health at TeamHealth, to discuss how post-acute care providers can better address substance use disorders (SUDs) through informed staffing, clinical training and evidence-based protocols. From transitions of care to medication-assisted treatment (MAT), Stone shares practical insights on screening, overcoming stigma and building a coordinated approach to behavioral health in skilled nursing settings. She also highlights TeamHealth’s role in supporting SNFs with the tools and expertise needed to close critical care gaps and improve outcomes for this often-overlooked patient population.
Skilled Nursing News: What life and career experiences most shape your approach to the work you’re doing today?
Jessica Stone: I’ve been passionate about behavioral health my entire life. I grew up with close family members who lived with chronic mental illness, so I was exposed to it early on. That personal experience really shaped my interest, and when I started learning more about it in school, it just clicked. It felt like a natural fit for me both personally and intellectually. I think I’ve always had an innate ability to connect with this population, and empathy has always come naturally to me.
Over the years, I’ve had the chance to work in a lot of different environments and bring in a wide range of experience. Honestly, I never thought I’d go into geriatrics or long-term care, but about 12 years ago, I moved to Charlotte and came across a job posting that caught my eye. That’s when I met Steve Mangano, our Executive Vice President for the service line, and thought, “you know what, let me give this a shot.” It ended up being such a great fit, and I completely fell in love with the work.
What really drew me in was the opportunity to treat any behavioral health condition or presentation, just in a long-term care setting. These are often underserved and vulnerable populations, and it’s a chance to make a real impact in their lives. That’s what keeps me passionate about the work we’re doing, and there’s so much perspective to bring into this space, especially at TeamHealth.
How does TeamHealth support post-acute care facilities with clinical staffing, training and behavioral health expertise when implementing substance use disorder care?
Stone: TeamHealth recognized a growing need for better support in managing substance use disorders in the post-acute care space. National data shows that substance use has increased by more than 50% among adults over the past two decades, yet most long-term care settings still don’t have the training or resources to manage it effectively. A lot of clinicians and facility teams feel unprepared. They often lack clear guidance, confidence and consistent protocols for managing these situations.
To address that, we developed a comprehensive substance use program within our post-acute behavioral health service line. It’s built around evidence-based treatment guidelines and tailored specifically for this setting. That includes standardized screening tools, clear processes, medication-assisted treatment, psychotherapy approaches and facility-specific workflows. A major focus is on motivational interviewing and the stages of change model, which helps guide residents through where they are in their recovery journey.
When you put all those elements together, we’re able to better equip our clinicians and partner facilities to deliver safe, consistent and effective care for residents dealing with substance use.
What strategies and protocols does TeamHealth utilize to ensure seamless continuity of care before and after placement in a post-acute setting?
Stone: Unfortunately, there’s a significant gap in continuity of care both before placement into post-acute settings and during the discharge process. TeamHealth is working to help fill that gap across post-acute care more broadly, but we see an even more prominent gap when it comes to substance use disorders. The main reason is lack of screening and awareness. These diagnoses are often underrecognized or underdocumented, which means patients don’t always receive the support they need.
Through our program, we’ve implemented structured education and standardized screening protocols specifically for this care setting. We train both clinicians and facilities to identify substance use disorders or potential concerns early in the admission process, so we can build awareness and develop care plans from the start. That way, residents receive the right level of support immediately.
We also focus on extending care after discharge. We work with facility teams to identify appropriate outpatient resources or community-based recovery options to support long-term recovery and relapse prevention.
Given that substance use disorders are often underdiagnosed, how do you encourage more consistent and practical screening in post-acute settings, and which screening tools have you found most effective?
Stone: As part of our program, we provide standardized screening tools along with education on how to use them effectively. The training is directed at both clinicians and facility teams to create consistency across the board. Some of the tools we use include the CAGE-AID, which helps identify at-risk substance use, the AUDIT-C for alcohol use disorders, and the DAST-10 for identifying substance use disorders across multiple substances.
These tools are practical, evidence-based and can be incorporated directly into the facility’s admission or evaluation workflows. That way, screening becomes part of standard care rather than something extra.
Can you share how post-acute clinicians adopt medication-assisted treatment in rehabilitation or long-term settings, particularly in terms of safety monitoring and coordination with specialty providers?
Stone: The biggest barrier to widespread adoption of medication-assisted treatment, or MAT, is really a lack of clinical education and confidence in implementing it. That’s often compounded by a persistent misconception that you need a special certification to prescribe these medications. Nationally, only about 25% of adults who need treatment for opioid use disorder receive the medications that are actually recommended and effective.
For example, buprenorphine or methadone treatment has been linked to a 76% reduction in overdose at three months and a 59% reduction at 12 months. But even with a strong evidence base showing benefits, we’re still not seeing consistent implementation. It’s worth noting that regulatory barriers have been reduced. Prescribers are no longer required to have the X-waiver to prescribe buprenorphine, which helps expand access to MAT.
In response to the confidence gap, we’ve built a prescriber guideline for MAT that’s specifically designed for the post-acute care setting. We’ve also created a peer mentor program, where less experienced clinicians can reach out to seasoned providers for real-time support and mentorship on how to safely prescribe and manage MAT in these environments.
In your experience, what are the barriers among post-acute facility staff toward recognizing and treating substance use disorders? How do you approach shifting that mindset?
Stone: One of the biggest barriers we see is stigma. There’s still this lingering belief that substance use disorders are too difficult to treat, or that the outcomes aren’t worth the effort. A lot of that comes from fear or past negative experiences. But often, those experiences had less to do with the patient or the diagnosis and more to do with the fact that those individuals didn’t have proper access to care or the right resources to begin with.
Education and confidence are a big part of the problem. Many facility staff haven’t received adequate training, so they don’t feel prepared—and that leads to hesitation. But the evidence shows that treatment for substance use disorders is effective. In fact, relapse rates for people in recovery are similar to those for chronic conditions like asthma or hypertension, around 40 to 60%. And when you combine medication management with behavioral therapies, the outcomes are even better. We see meaningful recovery and a real reduction in mortality.
These patients deserve the same level of dignity and care as anyone else dealing with a chronic illness, whether it’s heart disease, diabetes, COPD, or substance use disorder.
There are also legal and regulatory changes reinforcing that message. Facilities can no longer deny admission just because someone has a substance use history. For example, the Americans with Disabilities Act prohibits blanket denials for patients receiving treatment for opioid use disorder. There have even been recent lawsuits where facilities were found liable for denying care based solely on substance use.
So the shift we need isn’t just clinical. It’s ethical, legal and cultural. When we move past the stigma, we open the door to better outcomes and a higher quality of life for these residents. That’s where the biggest opportunity lies.
How has the stigma shifted in recent years, and what do you think that will look like in the future?
Stone: I think we’ve seen a meaningful shift in the way people view behavioral health overall. COVID really accelerated that. Before the pandemic, behavioral health wasn’t always seen as a primary concern, but now there’s a much broader recognition that it matters, and it needs to be addressed.
When it comes to substance use, though, the stigma still lags behind. We’re not quite there yet. But I am seeing more eagerness from facilities to access the right resources. Clinicians also want to help these patients, but they just don’t always feel like they have the tools or training to do it effectively.
So the willingness is there. It’s just a matter of continuing to build confidence and close those education gaps. That’s what’s going to move the timeline forward.
Fill in the blank: In 2026, substance use disorder treatment will be defined by…
Stone: Broad acceptance of SUD as a chronic medical condition and by meaningful improvements in access to high-quality treatment for this population.
Editor’s note: This interview has been edited for length and clarity.
TeamHealth partners with facilities nationwide to deliver compassionate behavioral health care. Our scalable clinical and operational models are designed to meet the unique needs of each organization while helping to improve access, outcomes and continuity of care. To learn more, visit www.teamhealth.com/behavioral-health
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].
