PALTtalk

AMDA On-The-Hill | End of the Year 2019

 
The latest policy news from Director of Policy and Advocacy Alex Bardakh.
 
Questions? Email Alex at abardakh@paltc.org
 

AMDA On-The-Go | Physical Therapy in PALTC

Episode 20: Physical Therapy in PALTC
Dr. Timothy Swenson PT, DPT, OCS, CMTPT
 Dr. Swenson holds a doctorate in Physical Therapy. He is a Board Certified Orthopedic Clinical Specialist, and certified to perform dry needling.
 
 
 
References:
Barbara Resnick, PhD, CRNP, FAAN, FAANP Interdisciplinary Interventions and Teams Are Good…Can We Move Beyond That? JAMDA, July, 2013
Physical Activity Guidelines Health.gov

AMDA On-The-Hill | MEDPAC MEETING AND HILL DAY

The latest policy news from Director of Policy and Advocacy Alex Bardakh, including a look back at another successful Hill Day.
* AMDA-On-The-Hill podcasts are not eligible for CMD credits
Questions? Email Alex at abardakh@paltc.org
Related Resources:
MACRA, MIPS and APMS: Current Requirements and Proposed Changes
Advanced Care Planning Series
Guide to PA/LTC Coding, Reimbursement, and Documentation

AMDA On-The-Go | Fall Risk Reduction

Dr. David Smith. M.D., FAAFP, CMD
Dr. Smith is President at Geriatric Consultants of Central Tx, P.A., an Area MHMR Board Member. He serves on various state committees and stakeholder taskforces. He is a Texas Medical Directors Assn. Board Member, and Past President of the American Medical Directors Assn.
 
 
References:
Dr. David Smith, Documented, Systematic and Individualized Communication With the Attending Physician for Fall Risk Reduction/Injury Mitigation Care Planning, JAMDA 8/18
Tinetti, ME, “Risk factors for serious injury during falls by older persons in the community”, JAGS, 1995
Soriano, TA, et al, “Falls in the community-dwelling older adult: a review for primary-care providers” Clin Interv Aging, 2007

AMDA On-The-Go | The Care of LGBT Persons in PA/LTC Setting

Tim Johnston, PhD
Tim R. Johnston, PhD is the Director of National Projects at Services and Advocacy for GLBT Elders (SAGE) and the National Resource Center on LGBT Aging. He is responsible for directing SAGE’s national training initiatives, developing training curricula, and providing consulting services to both aging and LGBT service providers. Before coming to SAGE Tim taught Philosophy and Women’s and Gender Studies at Stony Brook University. He has written scholarly and popular articles on gender and LGBT identity, and his first book Affirmation, Care Ethics and LGBT Identity will be published by Palgrave Macmillan in 2016. In addition to facilitating LGBT cultural competency trainings, Tim is a frequent speaker at national and international conferences.
References:
In The Care of LGBT Persons in The Long-Term Care Setting", AMDA White Paper

AMDA On-The-Go | An Approach to UTI Prevention, Management, and Treatment

David A. Nace, MD, MPH, CMD
Dr. Nace is an Associate Professor whose research focuses primarily on infectious disease in long-term care. His interest in antibiotic stewardship is funded by three AHRQ studies: two, for which he serves as co-investigator, are designing and testing a national antimicrobial stewardship toolkit for nursing facilities; the third, for which he serves as PI, will update guidelines for urinary tract infection (UTI) management and then implement a program to improve its management in 40 nursing homes in four states.
 
References:
Dr. Theresa Rowe, 2018 NHSN LTCF Training - Epidemiology and Prevention of UTI
Cohen CC, Choi YJ, Stone PW., Costs of Infection Prevention Practices in Long-Term Care Settings: A Systematic Review., Nursing Economics, 2016
Dr. David A. Nace, et. al. The Improving Outcomes of UTI Management in Long-Term Care..., JAMDA, 2018

AMDA On-The-Go | Opioids and Pain Management in PA/LTC

Jeffrey Nichols, MD, CMD
Dr. Jeffrey Nichols, CMD, is Chief Medical Officer of the Gouverneur Skilled Nursing Facility, a division of New York City Health + Hospitals. Dr. Nichols teaches both Geriatrics and Palliative Care fellows and is an Associate Professor at the NYU Langone Medical School as well as the Icahn Mount Sinai School of Medicine. Dr. Nichols is Board Certified in Hospice and Palliative Care as well as Geriatrics. A long time AMDA leader, he currently serves as AMDA's Treasurer and Finance Committee Chair and writes the Dear Dr. Jeff column for Caring for the Ages.
References:
M C Reid, et al. "Pain Management in Long-Term Care Communities: A Quality Improvement Initiative”, Annals of Long Term Care, 2015
Laura B. Farless, MD; Christine S. Ritchie, MD, MSPH / ”Challenges of Pain Management in Long-Term Care”, Annals of Long Term Care, 2012
Brat, GA, et al, “Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study”, British Medical Journal, 2018
“Aging and Addicted”: The Opioid Epidemic Affects Older Adults, Too”, Kaiser Health News, 2016
CMS Roadmap to Address the Opioid Epidemic, CMS.gov, June, 2018

AMDA On-The-Go | Optimistic Project

Kathleen Unroe, MD, MHA
Research Scientist, Regenstrief Institute Assistant Professor of Medicine, Indiana University School of Medicine Center Scientist, Indiana University Center for Aging Research Dr. Unroe is focused on health policy relevant research in long term care, including the use of palliative care and hospice in this setting, transitions of care, quality of medical care in nursing homes, and staffing models in long term care. She is co-PI of the Optimistic model project
 
References:
Unroe KT, Nazir A, Holtz LR et al. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project. J Am Geriatr Soc 2015;63:165-169.
Hickman, S. E., Unroe, K. T., Ersek, M. T., Buente, B., Nazir, A., & Sachs, G. A. (2016). An Interim Analysis of an Advance Care Planning Intervention in the Nursing Home Setting. Journal of the American Geriatrics Society, 64(11), 2385–2392.
Unroe, et. al., “Improving Nursing Facility Care Through an Innovative Payment Demonstration Project: Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care Phase 2”, Journal of the American Geriatrics Association, 2018

AMDA On-The-Go | Management of LTC Residents with Diabetes

Naushira Pandya, MD, CMD
Dr. Pandya is board certified in internal Medicine, Geriatrics, and Endocrinology. She is also a certified medical director of long-term care facilities, and a recognized authority in diabetes management in the elderly. In addition, she oversees the training of medical students, residents and fellows in Geriatrics, and is a research mentor students, residents and faculty. She has over 20 publications and is a national and international speaker. Dr.Pandya has held several state and national leadership positions, including the presidency of AMDA, Society for Post-Acute and Long-Term Care Medicine. She holds the distinction of being a Fulbright Senior Specialist Scholar in Geriatrics in Slovakia in 2009.
 
References:
Centers for Disease Control Diabetes Data, cdc.org
Munshi, M., et. al., Management of Diabetes in Long-term Care and Skilled Nursing Facilities: A Position Statement of the American Diabetes Association, Diabetes Care 2016 Feb; 39(2): 308-318.
Haas, Linda, Special Considerations for Older Adults With Diabetes Residing in Skilled Nursing Facilities, Diabetes Spectrum 2014 Feb; 27 (1): 37
McKnight’s Long Term Care News, August 5, 2015, profile on Naushira Pandya MD
Pandya N, et. al., Optimizing insulin delivery for patients with diabetes, Geriatric Nursing, 2018, 39:138

AMDA On-The-Go | Through the Eyes of an Administrator

“The world of long-term care is changing very quickly,” says Richard Bane, president of BaneCare Management. "We are not what people typically associate with a nursing home". This episode looks at the past, present, and future of Skilled Nursing Facilities through the eyes of an administrator with 35 years of experience.
References:
Code of Federal Regulations on Administration:  42 CFR 483.7, cms.gov
Code of Massachusetts regulations on Administration: 105 CMR 150, mass.gov
McKnights Long Term Care News, August, 2018–5 Star ratings and readmissions
“The Five-Star Rating System for Skilled Nursing: Perceptions and Effects”, www.lancasterpollard.com, June 10, 2017
“Skilled Nursing Facility Star Rating, Patient Outcomes, and Readmission Risk After Total Joint Arthroplasty”, Journal of Arthroplasty, June, 2018
American Health Care Association, ‘Quality Initiatives’, www.ahcancal.org