AMDA ON-THE-GO

“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

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

  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 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 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

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"

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

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.

  Kamal Wagle, MD, MPH, CMD; Dheeraj Mahajan, MD, CMD; John Derr, RPh Papanicolas, et. al., “Health care spending in the United States and other high-income countries”, Special Communication, JAMA, 2018 Ezekiel Emanuel, “The real cost of the US health care system”, Editorial, JAMA, 2018 Monane, et. al., “Optimal medication use in elders. Key to successful aging”, Western Journal of Medicine, 1997 Loganathan, et. al., “Interventions to optimise prescribing in care homes: systematic review”, Age Ageing, 2011

Roundtable discussion with University of Maryland Nurse Practitoner Doctoral candidates: Nadia Khan, MPH, BSN, RN, Lauren Meekins, RN, and Venessa Ohakam, NP. Template for an Antibiotic Stewardship Policy for PA/LTC Settings Daneman, et. al., “Variability in antibiotic use across nursing homes and the risk of antibiotic-related adverse outcomes for individual residents”, JAMA Int Med, 2015 “Nursing homes need improved antibiotic stewardship”, News from the Centers for Disease control and prevention, JAMA, 2015 Jump, et. al., “Template for an antibiotic stewardship policy for post-acute and long-term care settings, JAMDA, 2017 Castle, et. al., “Hand hygiene deficiency citations in nursing homes”, Journal of Applied Gerontology, 2012 Harris, et. al., “Appropriate antibiotic use of acute respiratory tract infection in adults: advice for high-value care from the American college of physicians and the centers for disease control and prevention”, Annals of Internal Medicine, 2016

Suzanne M. Gillespie MD, RD, CMD, FACP, AGSF 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. Dr. Gillespie is Associate Chief of Staff for Geriatric Extended Care – Rehabilitation and Medical Director of the Community Living Center at the Canandaigua VA Medical Center.  "The views expressed in this article are those of the speakers and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government." National Structural Survey of Veterans Affairs Home-Based Primary Care Programs Poster Abstracts:  Measuring Team Effectiveness in the Veterans Health Administration's Home-Based Primary Care Program A Comparison of Rural and Urban Veterans Health Administration's Home Based Primary Care JAMDA article referenced by Dr. Saltsman: Systematic Review of Interdisciplinary Interventions in Nursing Homes References: Papanicolas, et. al., “Health care spending in the United States and other high-income countries”, Special Communication, JAMA, 2018 Ezekiel Emanuel, “The real cost of the US health care system”, Editorial, JAMA, 2018 Monane, et. al., “Optimal medication use in elders. Key to successful aging”, Western Journal of Medicine, 1997 Loganathan, et. al., “Interventions to optimise prescribing in care homes: systematic review”, Age Ageing, 2011  

This podcast features a discussion with Arif Nazir, MD, FACP, CMD, AGSF, one of the authors of the JAMDA article "The Prevalence of Burnout Among Nursing Home Physicians: An International Perspective". Dr. Nazir is currently the vice-president of The Society. References: Schaufeli, et. al., “Burnout: 35 years of research and practice”, Career Development International, 2009 Shanafelt, et. al., “Burnout and Satisfaction with work-life balance among US physicians relative to the general US population”, Archives of Internal Medicine, 2012 Nazir, et. al., “The prevalence of burnout among nursing home physicians: an international perspective”, JAMDA, January 2018 Shanafelt, et. al., “addressing physician burnout—the way forward”, Viewpoint in JAMA, March, 2017  

In our first podcast, AMDA-On-The-Go host, Dr. Wayne Saltsman, MD, PhD, CMD, FACP, interviews Dr. Cari Levy, MD, PhD, CMD. The topic of discussion is the JAMDA article "Effects of Legal Access to Cannabis on Scheduled II–V Drug Prescriptions". Dr. Levi also discusses her first-hand experience with PALTC patients in Colorado and the need for further research in Cannabis use among older adults. Dr. Levy will be presenting at the AMDA Annual Conference in Grapevine, TX, March 22-25.