When Does a Client Need a Higher Level of Care?

At The Emily Program, we personalize each client’s care so they receive evidence-based treatment that matches the severity of their illness.

Determining the correct level of care ensures that our clients receive the most effective therapies for sustained recovery. Appropriate levels of care also decrease long-term health care costs associated with expensive but ineffective hospital stays that don’t address the core symptoms of eating disorders.

In cases for which a client needs additional structure and support beyond outpatient treatment, we offer higher levels of care, which include Residential Treatment and Partial Hospitalization/Intensive Day Programming (PHP/IDP). These programs involve intensive, supervised treatment designed to help clients reinforce recovery skills every day.

We understand that entering a higher level of care program is a big decision. We share our levels of care guidelines so our treatment recommendations are as transparent as possible. Our level of care guidelines are based on the American Psychiatric Association level of care guidelines for people with eating disorders.

Each client’s care level recommendation is determined by a variety of factors, including the following:

Medical status: A higher level will be recommended when medical and/or psychiatric monitoring is needed to manage and treat eating disorder and related complications.

Structure needed to decrease eating disorder behaviors: A higher level of care with a greater degree of structure and supervision will be recommended for those who need extra supervision and support managing eating behavior or weight or health restoration.

Degree of weight change necessary: The percent body weight change necessary over a specific period of time also goes into the level of care decision. If a client requires a large percentage of weight restoration or if their weight has changed rapidly, a higher level of care may be necessary to facilitate the necessary weight change and health restoration. 

Motivation for recovery: Given the characteristics of these illnesses, changing these behaviors can be incredibly challenging, even when a client is working very hard to get better. Additionally, lack of recognition of the seriousness of the illness can be part of the illness, making behavior change very challenging. Typically, a higher level of care is recommended if a client has been unable to adequately address and change eating disorder behaviors necessary for recovery in an outpatient setting.

Suicidality/Self-harm: If there is any indication that a client has thoughts about self-harm, they will be recommended for a higher level of care with appropriate supervision.

Exercise: A higher level of care may be recommended if compulsive and/or excessive exercise is an issue for a client and they need significant structure or supervision to control the activity and integrate change around activity.

Social support: Another factor in determining level of care is the amount of social support available to a client. Clients with limited support outside the treatment setting may be recommended for a higher level of care so staff can offer extra support to clients in need and work with the client to set up a more robust support system to be in place at discharge.

Distance from treatment: A practical consideration for determining the level of care is what treatment the client has access to locally. If adequate lower level of care is not available near them, the client may need to travel to a residential or PHP/IDP facility for more intensive treatment.

While these guidelines are a primary resource for determining care levels, each client situation is unique and individual clinical judgment of the referring provider plays a major role in the recommendation.

We admit patients to higher levels of care in our facilities in Minnesota, Ohio, or Washington as quickly as possible. We verify insurance benefits and connect you and your patient with a Phone Intake Therapist/Nurse, who will complete a phone intake, secure the necessary medical data, schedule an admission date and facilitate any necessary lodging.

The Phone Intake Therapist/Nurse will help you and your patient every step of the way. We will involve you from admission to discharge, to provide the smoothest transition possible.

If you have a patient in need of eating disorder treatment at any level, call Admissions at 1-888-364-5977 or fill out our Refer a Patient web form. Together, we can help your client take the next step in recovery.