PALTtalk

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

AMDA On-The-Go | Management of Sepsis

Episode 12: Sepsis with Dr. Bernardo Reyes Fernandez / Coming Soon!
Bernardo Reyes, MD., is a board-certified internist and geriatrician, he serves as Assistant Director of the Internal Medicine Residency Program and Associate Director of the Geriatric and Palliative Rotations and Assistant Professor of Clinical Biomedical Science in the Charles E. Schmidt College of Medicine at Florida Atlantic University (FAU).
References:
Fernandez, "Early Identification and Management of Sepsis", JAMDA, June 2018
Sloane, P, et al, “Can sepsis be detected in the Nursing Home Prior to the Need for Hospital Transfer?”, JAMDA, June, 2018
Dantes R and Epstein L, “Combatting Sepsis: A Public Health Perspective”, Clinical Infectious Diseases, May, 2018

AMDA On-The-Go | Predictive Models of Care

 
Dr. Burke is the first Director of Research for the Hospital Medicine Section at the University of Pennsylvania and an Assistant Professor of Medicine at the Perelman School of Medicine. Dr. Burke's research seeks to improve the outcomes associated with transitions from the hospital to post-acute care in vulnerable populations. 
 
References:
Burke et. al., "Predicting Potential Adverse Events During a Skilled Nursing Facility Stay: A Skilled Nursing Facility Prognosis Score" JAGS, 2018
Jencks, M.D., M.P.H., Williams, M.D., and Coleman, M.D., M.P.H., "Rehospitalizations among Patients in the Medicare Fee-for-Service Program" NEJM, April 2009
Burke et. al., "Hospital Readmission From Post-Acute Care Facilities: Risk Factors, Timing, and Outcomes", JAMDA, March 2016

AMDA On-The-Go | Innovation

AMDA On-The-Go launched in March of 2018. Since March, we have released ten episodes and would love to hear your feedback. Even if you haven't listened, please fill out this brief survey so we can improve this free benefit.
Innovations with Dr. Steven Buslovich and Adam Sobol
 
Dr. Steven Buslovich is Geriatrician and Medical Director for several post-acute/LTC facilities in Western NY and co-founder, CEO of Patient Pattern. Also, on faculty at University of Buffalo, School of Medicine. 
Learn more by visiting Patient Pattern’s website: patientpattern.com/
 
 
 
Adam Sobol is founder and CEO of CareBand, an innovative, patent-pending wearable technology for senior citizens that are experiencing a decline in their mental and physical health. CareBand aims to increase the safety and independence of senior citizens giving caregivers and family members peace of mind. 
Learn more by visiting Careband’s website: https://carebandremembers.com/

AMDA On-The-Go | Core Competencies

AMDA On-The-Go launched in March of 2018. Since March, we have released nine episodes and would love to hear your feedback. Even if you haven't listened, please fill out this brief survey so we can improve this free benefit.
Paul Katz, MD, CMD, is Professor of Medicine and Director of the Department of Geriatric Medicine, Florida State University, and a Past President of the American Medical Director's Association. He is the lead physician of the Working Committee of the Seniors Quality Leap Initiative, representing Baycrest Centre for Geriatric Care.
Reference:
Katz, “A Call to Action” JAMDA, 2010
Katz and Pfell, “Nursing home physicians and the credibility gap”, JAMDA, 2012
Katz, et. al., “Examining the rationale and processes behind the development of AMDA’s competencies for post-acute and long-term care", Annals of Long Term Care, 2014

AMDA On-The-Go | Public Policy

Dr. Karl Steinberg currently chairs AMDA's Public Policy Committee, serves on the AAHPM's Public Policy Committee, and is also immediate past chair of the Coalition for Compassionate Care of California. Dr. Steinberg has worked as a geriatrician, family physician and hospice physician in San Diego County since 1992. He is a Past President and current President-Elect of the California Association of Long Term Care Medicine (CALTCM), which is the state chapter of AMDA--The Society for Post-Acute and Long-Term Care Medicine (formerly the American Medical Directors Association). He also is editor-in-chief of AMDA's periodical, Caring for the Ages.
References:
 
“Why Health Care Policy is so Hard”, New York Times, 7/28/17
“The future of US health care”, RAND Health, 2017
"Nursing home reform act of 2017"

AMDA On-The-Go | Frailty

Frailty with Philip D. Sloane, MD, MPH
 
Dr. Sloane is the Elizabeth and Oscar Goodwin Distinguished Professor of Family Medicine at the University of North Carolina at Chapel Hill. Recently selected as Co-Editor in Chief of JAMDA, Dr. Sloane has authored over 200 peer-reviewed publications and co-authored two popular text books. He is particularly noted for his work around the management of behavioral symptoms in Alzheimer’s disease, for which he received the prestigious Pioneer Award from the US Alzheimer’s Association. An advocate for change and improvement in primary care medical practice, he founded the North Carolina Family Medicine Research Network and the North Carolina Network Consortium, which conduct research statewide.
References:
Philip Sloane, MD, MPH; Matteo Cesari, MD, PHD "Research on Frailty: Continued Progress, Continued Challenges" JAMDA, 2018
Philip Sloan et. al., "Nutritional, Physical, Cognitive, and Combination Interventions and Frailty Reversal Among Older Adults: A Randomized Controlled Trial" The Amereican Journal of Medicine, 2015
Llibre Rodriguez et. al. "The Prevalence and Correlates of Frailty in Urban and Rural Populations in Latin America, China, and India: A 10/66 Population-Based Survey"JAMDA, 2018
Liu et. al., "Joint Trajectories of Cognition and Frailty and Associated Burden of Patient-Reported Outcomes"JAMDA, 2018
Alegre et. al. "An Easy Assessment of Frailty at Baseline Independently Predicts Prognosis in Very Elderly Patients With Acute Coronary Syndromes" JAMDA, 2018
Ntanasi et. al. "Adherence to Mediterranean Diet and Frailty", JAMDA, 2018
Fried, et. al., "Frailty in older adults: evidence for a phenotype", Journal of Gerontology, 2001
Jones, et. al., "Evaluation of a Frailty Index based on a comprehensive geriatric assessment in a population based study of elderly Canadians", Aging Clinical and Experimental Research, 2005
Rockwood, et. al., "A Global Clinical Measure of Fitness and Frailty in Elderly People", CMAJ, 2005

AMDA On-The-Go | Telemedicine in PALTC

Thomas Edmondson, MD, CMD
Tom Edmondson, MD, CMD, AGSF, FACP, is a native Texan who graduated from the University of Texas Medical School at Houston, and he completed his residency training in internal medicine at the University of Texas Southwestern Medical Center and Parkland Memorial Hospital.
 
 
Suzanne Gillespie, MD, RD, CMD
Suzanne Gillespie MD, RD, CMD, is Associate Professor of Medicine in the Division of Geriatrics/Aging and Associate Professor of Emergency Medicine at the University of Rochester School of Medicine and Dentistry. She is board-certified in Internal Medicine, Geriatric Medicine and Hospice & Palliative Medicine.
 
 
 
Murthy Gokula, MD, CMD
Murthy Gokula, MD, CMD, is CEO of STAYHOME IWILL PC and Clinical Associate Professor of Family Medicine at the University of Toledo, College of Medicine. He teaches medical students, residents and fellows in the long term care setting. Dr. Gokula is the current president of Ohio Medical Directors Association (OMDA), former board member of OMDA, former program director of Geriatrics Fellowship Program at University of Toledo. He serves on the editorial board for Journal of American Medical Directors Association (JAMDA).
 
 
Steven Handler, MD, PhD, CMD
Steven Handler, MD, PhD, CMD, is an Associate Professor with a primary appointment in the Division of Geriatric Medicine, where he serves as the Director of Geriatric Telemedicine Programs. He has secondary appointments in the Department of Biomedical Informatics, and Clinical and Translational Research.