by CALTCM LMG Faculty

Dan Osterweil, MD, FACP, CMD, Ethan Cumbler, MD, FACP, FHM, and Michael Wasserman, MD, CMD

The original course entitled Leadership & Management in Geriatrics (LMG) was established at UCLA over 15 years ago, and has hundreds of proud alumni.  That course, which continues annually under the sponsorship of CALTCM, is focused on individual leaders serving in diverse organizations with many different roles and responsibilities.

In 2018, LMG faculty went beyond training individuals, by creating a new focus on nursing facility teams. Recognizing that a key factor in successful long term care facilities is the leadership team, we developed “LMG for Nursing Homes” (LMG-NH).  Bringing Administrators, Directors of Nursing, Directors of Staff Development, and Medical Directors together to introduce key leadership and management constructs for the “free flowing” NH environment, participants dove into implementation strategies and tactics. The major themes included practice improvement, goal setting and management of human talents, provided under a QAPI (Quality Assurance and Performance Improvement) umbrella. In addition, participants are able to obtain additional support through post-course faculty mentorship.

CALTCM conducted four LMG-NH sessions in 2018, geared toward training leadership teams drawn from the largest consortium of facilities in California. The revised curriculum was designed to meet the needs of the multi-disciplinary management team. This was, to our knowledge, the first state-wide professional workshop bringing physicians, administrators, and nurses together under one roof.  Click here to view short photo slide show of 2018's LMG events.

A unique aspect of LMG is alumni access to course faculty for a mentored post-course change initiative within the participant’s local institution. Graduates of the course have lead successful quality improvement initiatives, re-designed care processes, developed new programs, and tackled institutional culture change.  LMG provides participants both continuing education and American Board of Internal Medicine Maintenance of Certification credits.  

Dr. Dan Osterweil, Professor of Medicine at UCLA, a founder and faculty member of LMG since its inception in 2002, opened the two day workshop with an overview of the interface between geriatrics, nursing homes and today’s complex healthcare marketplace.  

Dr. Alfredo Czerwinski, Chief Medical Officer for Lawson & Associates, led the group through the two day workshop. Today’s nursing homes are yesterday’s hospitals, and how medical directors interact within the leadership team is a core element in achieving success. Dr. Czerwinski’s years of experience mentoring physicians on how to effectively engage complex health systems are brought to bear through topical case studies and utilizing the combined knowledge and insight of the entire faculty.

Dr. Mike Wasserman, CALTCM’s President, laid out a plan to improve professional competencies and professional accountability of nursing home leadership. Each nursing home was treated as a separate business unit responsible for its own performance and financial viability. He emphasized the importance of providing person centered care while adhering to sound geriatrics practice as the key to economic success. Dr. Wasserman led the teams through a series of role playing exercises, to highlight the opportunities hidden in the survey process and operational challenges involving all members of the leadership team.

Dr. Deb Bakerjian, Professor of Nursing at UC Davis School of Nursing, prepared the foundation to effectively develop and implement quality assurance and performance improvement (QAPI) programs, a CMS mandate with complexguidancethat now requires the oversight of the nursing home governing body. Participants spent hours brainstorming and developing action plans for their respective facilities with the LMG faculty acting as mentors.

Dr. Ron Cohn, an organizational psychologist, took the participants through a series of conflict resolution strategies. The interplay between the day to day business operations of a nursing home and the clinical needs of the residents, provide a challenging backdrop for difficult interpersonal dynamics.  How facility leadership rises to these challenges is a core component of the two day workshop. Participants were given the opportunity to learn from real-life examples in a learning friendly environment.

Dr. Ethan Cumbler, Professor of Medicine at the University of Colorado School of Medicine, brings unparalleled motivational skills to team building.  Meshing various team members’ skills and personalities to develop and implement effective programs is at the core of the LMG-NH program. Dr. Cumbler also brings together the ongoing challenge of finding value-driven equations in today’s complex healthcare marketplace.

Dr. Cari Levy, President of AMDA (Society for Post-Acute and Long Term Care Medicine), challenged the participants to heighten their creative skills in order to stay motivated and effective in a very stressful working environment.  Through short “Theory Bursts,” she led the group through key concepts of leadership including how to relax and avoid burnout.

Dr. Rebecca Ferrini, a full-time medical director for a 5 star award winning San Diego County nursing facility, shared her knowledge and insightful experiences with the group.  Her presentation on how to run an effective meeting will certainly be used by participants to bring more effective communications to their facilities.

Dr. David Farrell, co-author of Meeting the Leadership Challenge in Long Term Care, brought his many years of experience as a Nursing Home Administrator in sharing key elements for implementing effective culture change.  Participants came away from his thought provoking lecture with clear direction on achieving successful outcomes without being a slave to numbers.

By developing and improving these four LMG-NH programs in 2018, CALTCM is excited to have developed a ground-breaking workshop that we believe can provide key education and training to nursing home leadership teams in the coming years.  CMS requirements for QAPI, the complexity of NH culture, and the new paradigm shift brought on by PDPM (patient driven payment model), necessitates this type of forward thinking and collaborative program. LMG-NH combines a business orientation with clinical realities to a goal oriented leadership and management training program.  

The days of position-specific training in long term care are officially over! If you are interested in bringing LMG-NH to your facility or organization, please contact Barbara Hulz at 888-332-3299 or email at [email protected]