by Tim Gieseke MD, CMD, Chair, Education Committee

In 2012, CDPH sponsored a collaborative partnership with multiple stakeholder organizations to improve dementia care and reduce unnecessary use of antipsychotics in SNFs.  CALTCM has been a part of this partnership and sponsored a half-day workshop on Dementia Care as a pre-conference addition to our April 2013 annual meeting.

All participants in this partnership realize there is still much work to be done.  California Culture Change Coalition (CCCC) has become the lead organization in this effort and has obtained some funding to help facilities implement the necessary changes.  Members of our BOD will be participating this summer in further meetings to assist stakeholders in specific next implementation steps.

In the interim, I have created a summary presentation identifying the elements of a comprehensive dementia care program.  This presentation is now posted on our web site.

by Donna Renee Williams,  RN, MBA, CDONA/LTC

According to an ACHA report published in March of 2012, there were 15,690 nursing homes in the United States accounting for 1.7 million patients and residents.  According to an article published by US News in March 2011, “Nursing homes that did the best on quality measures were only a little less likely to be sued. In any given year, nursing homes with the best records (the top 10 percent) had a 40 percent risk of being sued, while the worst 10 percent of nursing homes had a 47 percent chance of being sued.”

Physicians carry malpractice insurance to cover their practice; however, nurses often do not.  Nurses instead are reassured that the organization has insurance and will cover them in the event of litigation.  Yet, the question is, ultimately who does the attorney provided by the organization represent?

by Jay Luxenberg, MD

People use their tablet for a variety of purposes. I find my iPad a very useful supplement for the memory I no longer have. I’d like to base my practice on the best of the large randomized trials that are out there. I think there must have been a time when my brain sufficed to keep the acronyms straight – remembering them all from AASK (intensive blood-pressure control in hypertensive chronic kidney disease, published in NEJM 2010) to WOSCOPS (prevention of coronary heart disease with pravastatin in men with hypercholesterolemia, also in NEJM, 1995). As the number of trials and the crazy acronyms have proliferated, my cortex has not been able to keep up with the challenge. Thus the role of an iPad app called MyStudies. It presents the data on 228 complete studies (and is frequently updated). It works on a subscription model, with the app free and the annual subscription currently $10.

by Jay Luxenberg, MD

On May 24, CMS posted an update entitled Advanced Copy: Dementia Care in Nursing Homes: Clarification to Appendix P State Operations Manual (SOM) and Appendix PP in the SOM for F309 – Quality of Care and F329 – Unnecessary Drugs.  This document includes a color-coded version of these sections of the States Operation Manual indicated exactly where the changes have been made. They have also posted three mandatory surveyor training videos that we can view that are intended to train the surveyors on this topic. It is well worth your time reviewing this material, which is surely going to influence future surveys.  Pay attention to the examples in the videos, indicating what the surveyors are being told constitutes actual harm and immediate jeopardy.