The questions that don't make it into the first email

How is this different from an onsite psychiatrist who comes once a month?

Frequency and follow-through. A monthly visit sees whoever is on the list that day; the resident whose behavior changed the next morning waits for the next one. A standing weekly clinic sees the residents who need it, when the need shows up, and keeps open items on the list until they close. The visit is live video with your staff in the room; the onboarding and leadership meetings are in person.

Do you replace the attending or our emergency process?

No. The attending keeps authority over the resident’s orders and every recommendation routes through them. Emergencies stay on your existing process — 911, the attending, transfer. We are scheduled coverage, not a crisis line and not an onsite hospitalist.

What happens between clinics?

Urgent questions about a resident already on the panel go to your coordinator and are triaged into the next available clinic slot. Anything unsafe now runs through your emergency process — 911, the attending, transfer — not through us.

Do you write the orders, or recommend?

Recommend. Every note goes to the attending, who keeps authority over the resident’s orders, and to nursing through your routing. If a recommendation isn’t implemented, that’s a conversation at the next clinic, not a silent gap in the chart.

We have an incumbent psychiatric provider under contract.

Then we start by asking about the contract and the notice period. We won’t ask you to breach an exclusive agreement. If the incumbent can be supplemented, a weekly clinic can sit alongside them; if it can’t, we’ll say so and check back when the term ends.

How many residents would you see?

A typical panel runs about 6–12 medically necessary visits a week when the census supports it. That’s a planning range so your coordinator can hold a slot, not a quota. Some weeks are lighter. The number follows medical necessity.

Who pays?

The facility doesn’t pay for the clinic. Visits are billed to the resident’s coverage. Original Medicare is covered. Medi-Cal managed-care plans vary by plan and facility, and Medicare Advantage depends on network participation and authorization, so we sort out the payer mix before the first clinic. Every encounter is verified for coverage, eligibility on the date of service, and medical necessity, and nothing here is a payment guarantee.

Didn’t Medicare change the telehealth rules for nursing facilities?

It did. The 2026 physician fee schedule removed the former frequency limit on subsequent nursing-facility telehealth visits, and the visits sit on the CMS telehealth services list. That’s policy. It doesn’t make any individual encounter payable, which is why every one is verified.

Sources: CMS CY 2026 Physician Fee Schedule final rule fact sheet · CMS telehealth services list

What do we need to provide for a visit?

A private room, a video device that works, and a staff member to bring the resident in and stay when it helps. Before the clinic, the census for the day and the collateral that matters — current orders and eMAR, recent notes, the behavior log. PointClickCare is the common and preferred pathway.

Who signs the agreement and the BAA?

Your administrator or owner, and Horizon Peak Health. Nothing about any resident is shared before both signatures. The BAA template is available on request through the facility inquiry.

Is any of this automated?

Care is clinician-led. Every evaluation is done live by a licensed clinician, every recommendation is that clinician’s judgment, and every note is signed by the clinician who saw the resident.

What will you never promise?

A survey result, automatic GDR approval, a medication reduction by a target number, that a resident won’t be hospitalized, that an encounter will be paid, or a start date before contracting and credentialing are done. We also won’t discuss any facility’s deficiencies, star rating, or antipsychotic rate in public.