PALTtalk

AMDA On-The-Go | Treating and Preventing C Diff

Milta Little, DO, CMD
Milta Little, DO, CMD, is an Associate Professor of Medicine at St. Louis University in the Division of Geriatric Medicine. She is board certified in General Internal Medicine, with added qualifications in Geriatric Medicine. She serves the division as Program Director of the Geriatric Medicine Fellowship. Her primary scholarly interest is interprofessional health education to improve the care of the frail geriatric patient. Dr. Little has been on the St. Louis Magazine Best Doctor list since 2013. She is a Certified Medical Director and as such, has been a medical director at a number of Skilled Nursing Facilities. She served AMDA on the board of directors from 2012-2016 and from 2017 to present.
 
References:
M. Little, "TREATING AND PREVENTING CLOSTRIDIUM DIFFICILE INFECTION IN LONG-TERM CARE FACILITIES", Managed Healthcare Connect, Nov, 2018
C. McDonald, et. al."Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)", Clinical Infectious Diseases, Volume 66, Issue 7, 19 March 2018
Leffler, DA and Lamont JT, "Clostridium difficile Infection”, New England Journal of Medicine, 2015
Lessa, FC, et. al., “Burden of Clostridium difficile Infection in the United States", New England Journal of Medicine, 2015

AMDA On-The-Go | Ethics - SED by AD

Ethics - SED by AD
James Wright, MD, PhD, CMD
James Wright, MD, PhD, CMD, is Vice Chair of AMDA-PALTC’s Ethics Committee. He holds a Masters of Arts in Theological Studies from Union Presbyterian Seminary and a Certificate in Bioethics from Loyola University, Chicago. Dr. Wright is currently writing a book addressing the theological, medical and ethical implications of dementia, called “Love Endures”. He is medical director of three facilities in Richmond, Virginia.
References:
AMDA White Paper, "The Role of a Facility Ethics Committee in Decision-Making at the End of Life", March, 2008
Paula Span, "The VSED Exit: A Way to Speed Up Dying, Without Asking Permission", York Times, 2016
Ivanovic, N., et al, "Voluntary stopping of eating and drinking at the end of life - a 'systematic search and review' giving insight into an option of hastening death in capacitated adults at the end of life.”, BMC-Palliative Care, 2014
Wax, J. et al, "Voluntary Stopping Eating and Drinking”, Journal of the American Geriatrics Society, 2018

AMDA On-The-Go | SNF / ER Transition Process

Episode 21: SNF/ER Transition Process
Dr. Adam Perry
 
Adam Perry, MD, is an emergency physician and fellowship trained geriatrician. He is Assistant Professor of Medicine at the Geisinger Commonwealth College of Medicine. He is also a faculty member of the Geriatric Emergency Department Collaborative, in which capacity he presents nationally on clinical and quality improvement topics at health systems implementing emergency department geriatric initiatives.
 
 
References:
Gettel et. al. The Impact of Incomplete Nursing Home Transfer Documentation on Emergency Department Care", JAMDA, October, 2018
Adam Perry, MD; Firas Saidi, MD, CMD "The Emergency Department Joins the Interdisciplinary Team: Strategies to Improve Acute Care Transitions and Reduce ED Capture", AMDA Annual Conference, Grapevine, TX
Robert Burke, et al. "Identifying Potentially Preventable Emergency Department Visits by Nursing Home Residents in the United States", JAMDA, 2015

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