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CMS to Hold off on Mandatory Consultant Pharmacist “Independence” |
by Flora Brahmbhatt, Pharm D, CGP
In October 2011, CMS indicated that it was considering mandating the separation of a facility’s consultant pharmacist from its long term care dispensing pharmacy. In April 2012, CMS reached the conclusion that this transition would be disruptive and would not solve the issue of chemical restraints.
Instead, CMS is extending the comment period and encouraging the separation but not insisting on it. CMS has restated the importance of paying “fair market” value for consulting services. Additionally, CMS is encouraging the consultant pharmacist and the facility to reach an integrity agreement to avoid any conflict in interest.
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Jay S. Luxenberg, MD
It seems like every decade or so we have a new iteration of the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. The last one was in 2003, and now we have a new update with a handy, dandy pocket guide and promise of a mobile app clinical tool in the near future. I think that the impact of the new criteria will be fostered by the fact that more and more of us are using electronic health records. I used the criteria to generate some reports, and found plenty of room for improvement. The latest iteration both eliminates references to archaic drugs and adds reference to many new drugs. The criteria take into account recent studies and black box warnings. For example, for antipsychotics the criteria state, "Avoid use for behavioral problems of dementia unless non-pharmacologic options have failed and patient is threat to self or others." Note that "and" – they are really saying that unless the patient is a threat to self or others, then antipsychotics should be avoided – that is a step beyond previous advice that simply said when non-pharmacologic approaches failed to eliminate the troublesome behaviors. If you haven't had a chance to review these new recommendations, please take this opportunity to download them. I am sure there will be discussion of aspects of the new recommendations at our national meetings and at the upcoming CALTCM 38th Annual Meeting. |
CALTCM Member Profile: Janice Marie S. Diez, MSN, BSN, RN, CNL, CWCA, DON-CLTC |
Please provide a brief background of your training and practice setting and years in practice.
I have been in healthcare profession for 21 years and the last 5 years was in the nursing profession. I earned my Doctor of Optometry in the Philippines, practiced for 16 years as a clinician and as Dean of Optometry in Cebu Doctors' University. I had my BSN in 2006 and started my nursing career in long-term care in 2007. Pursuing graduate studies in University of San Francisco as CNL (Clinic Nurse Leader) came as a natural interest and I'm currently contemplating applying to a PhD program in Geriatrics in 2013. After a year of being a charge nurse, I became a Director of Nursing, which I am still doing, and recently moved to Central Valley and joined Covenant Care family. I am a certified wound care associate and ongoing with my nursing rehabilitation certification.
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Farewell (and Hello!) from Dr. Osterweil |
Dan Osterweil, MD, FACP, CMD | CALTCM President
As we count down to our annual meeting, I want to take a moment to thank you for the opportunity to serve as the Association’s president. The last three years were marked by exciting opportunities and challenges for everyone in long term care. Despite the looming budget cuts, we have all joined together to find ways to improve how we deliver care. CALTCM has taken a leadership role in pushing a new concept- Performance Improvement Education (PIE) in lieu of the traditional CME. What defines PIE is a desire to improve performance by implementing appropriate care processes and quality improvement methods.
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CDPH and ASCP phone conference for consultant pharmacists report |
Flora Brahmbhatt, PharmD, CGP
On January 23, 2012, the pharmacist with the CDPH and the CA chapter of ASCP hosted a phone conference for consultant pharmacists. CDPH outlined specific expectations of the consultant pharmacist. Specifically, the role the consultant should take during the survey process. Per CDPH consultant pharmacists should visit the facility, introduce themselves to the surveyors and leave contact information to facilitate an open line of communication.
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