CAHF 2018 Summer Conference

• Network with thought leaders;
• Obtaining cutting-edge updates on regulatory and bioethical issues in nursing facility practice;
• Represent your team and building pride and collaboration.

Mike Wasserman, MD, CMD

The Geriatrics Approach to care is critical to achieving clinical success in long-term care. Understand this care philosophy with examples of its impact on common clinical conditions, common drug classes open for de-prescribing and guidelines for sliding scale insulin.  

• Understand the Geriatrics Approach to care. 
• Describe common drug classes open for deprescribing. 
• Understand the guideline for sliding scale insulin in long-term care. 

Understand the basic principles of wound care and discuss the challenges in managing wounds at long-term care facilities.

Learning Objectives:

• Describe different wound types etiologies
• Correctly classify stages of pressure ulcers
• Identify key team members and roles for delivering wound care in the post-acute setting
• Implement measures to improve outcomes and prevent hospitalizations in wound patients

A health care attorney and a bioethicist medical director discuss the latest in the CANHR v. Chapman case and appeal, which may invalidate the IDT decision-making process for incapacitated, unrepresented nursing home residents. They’ll focus on end-of-life care and antipsychotics but will also address the larger ethical discussion.

• Explain the issues that resulted in the filing of the CANHR v. Chapman case, challenging HSC 1418.8 (Epple), and the trial court's findings. 
• Describe likely ramifications of various appeals court rulings on this matter, with respect to how nursing homes will be able to provide care to the unrepresented incapacitated resident. 
• Consider the larger implications of this case on public health, hospitals, and the ability of health care systems to care for this growing segment of the population (the unrepresented incapacitated person). 

Falls, skin breakdowns and patient declines are often the focus of elder neglect claims and civil litigation. We’ll examine federal regulations and guidelines and offer practical advice for rendering care to disprove these claims.

• Identify most frequent fact patterns that create the basis of claims.
• Review Federal Regulations and the Standard of Care that define "unavoidable." 
• Provide best practice tips for providing care to establish "unavailability."
• Provide best practice tips on the charting necessary to establish "unavailability."

The Physician Orders for Life-Sustaining Treatment (POLST) is a highly-charged topic in skilled nursing facilities. We’ll highlight common problems associated with advance care planning (ACP) and POLST, including implications for reducing hospitalizations.

• Describe the appropriate patient population for POLST completion (hint: it's not appropriate for all nursing home residents) and the reasons for these criteria.
• Explain how appropriate POLST conversations and orders help ensure that our residents get the medical treatments they want, and how this can reduce a facility's hospitalization rates.
• Differentiate between advance health care directives (AHCD) and POLST, and who should complete them.
• Appreciate the dangers of POLST completion for inappropriate residents, especially in light of potential California legislative efforts (e.g., AB 937).