by Heather D’Adamo, MD

Post-Acute and Long Term Care is hard! Don’t do it alone. Join us May 17-19, 2018 for our Annual conference and find new ways to strengthen your community through teamwork and collaboration and to work smarter through clinical and administrative updates.

New this year, instead of our popular but brief medico-legal case, we have added an entire Pre-Conference on Thursday night focusing on medical-legal issues, which will include cases presented by attorneys who handle cases in Nursing Home care. They have seen it all, so you don’t have to.

Did you know that the Centers for Medicare & Medicaid Services (CMS) has changed the reimbursement structure for nursing homes starting October 2018? A new factor that will contribute to your nursing home reimbursement includes hospital readmissions. If you want to improve staff knowledge on new readmission quality measures, identify strategies to strengthen your readmission prevention program and be a preferred provider – join the HSAG Reducing Readmissions Preparation Program today!

Everyone knows the importance of good, restorative sleep, no matter what kind of physical health a person is in. It's even more important for frail elders and post-acute patients recuperating from a hospitalization from surgery or illness. To that end, CALTCM has been collaborating with the California Association of Health Facilities (CAHF)'s Quality Subcommittee, Diagnostic Laboratories (Schryver), Empira and others to promote some specific initiatives that will impact our residents' sleep in a very positive way.

by Flora Bessey, Pharm.D., BCGP

Concealing medications, a pharmacist’s response….

As a consultant pharmacist, facilities depend on us to show them the way with regards to medications.  One issue as described in a vignette by Dr. Luxenberg last month deals with hiding of important psychotherapeutic medications in the resident’s food to ensure consumption.  The short and simple answer to this is we can’t do it. Period.  No matter how vital the medications are, no matter how sick the resident is, they retain their right to refuse.  This appears in the law and across regulations. (42 CFR §483.10(f)(2)

The only exception may be if the resident is conserved.  Conservatorship is vastly different from authorization granted by the responsible party or family.  With conservatorship, the patient has been deemed incapable of making their own decisions and the court has appointed a conservator.  This person may be a family member, but it is someone who has been appointed by the court.