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Thursday, March 22
 

8:00am MST

TH2 | Updates in Management of Common Infections in PA/LTC Facilities
This session will highlight diagnostic challenges faced by providers when managing common infections (pneumonia, urinary tract infections and Clostridium difficile infections) in PA/LTC facilities, along with providing treatment updates. In addition, speakers will discuss strategies for prevention and early recognition of these infections. The audience will have the opportunity to seek answers for practical questions that they come across in their daily practice while managing common infections. This session will combine short presentations with interactive role-play session, small group case-based discussions, and an interactive panel discussion towards the end of the workshop.

Learning Objectives:
(1) Describe various clinical presentations of pneumonia, UTI and CDI in PA/LTC setting.
(2) Discuss the diagnostic challenges for pneumonia, UTI and CDI and the limitations of the available tests.
(3) Demonstrate practical steps that can be taken for prevention and early recognition of the common infections in the PA/LTC facilities.
(4) Review the treatment updates for pneumonia, UTI and CDI.

Speakers
avatar for Dheeraj Mahajan, MD, CMD

Dheeraj Mahajan, MD, CMD

Dheeraj Mahajan, MD, CMD, CIC, is currently the President and CEO of CIMPAR, S.C. (Chicago Internal Medicine Practice and Research). He also holds an academic appointment as the Clinical Assistant Professor of Medicine, University of Chicago, Illinois. In addition to being President... Read More →


Thursday March 22, 2018 8:00am - 11:30am MST
Texas 1-2
  Clinical Medicine

8:00am MST

TH3 | Latest Approaches to Difficult Medical Issues in PA/LTC
This popular session, by four experienced speakers from Saint Louis University and the University of North Carolina, will present an intensive session covering current and difficult clinical topic in the care of frail elders in the continuum of care. Topics will reflect best recent medical evidence, evidence-based guidelines, and current health care best practices.

Learning Objectives:
(1) Consider a multi-faceted approach to manage lower extremity mobility and polysubstance abuse in PA/LTC.
(2) Discuss treatment options for epilepsy and hepatitis management in PA/LTC.
(3) Use guidelines for management of anemia and vaccination in PA/LTC.
(4) Choose appropriate medications for joint pain and osteoporosis in PA/LTC.

Speakers
avatar for Milta Little, DO, CMD

Milta Little, DO, CMD

Milta Little, DO, CMD, is an Associate Professor of Medicine at St. Louis University in the Division of Geriatric Medicine. She is board certified in General Internal Medicine, with added qualifications in Geriatric Medicine. She serves the division as Program Director of the Geriatric... Read More →
avatar for Julie Gammack, MD, CMD

Julie Gammack, MD, CMD

Julie Gammack, MD, CMD, is a Professor of Medicine at St. Louis University School of Medicine. She is the Associate Dean for Graduate Medical Education, past Program Director for the Geriatric Medicine Fellowship, and a Medical Director at a teaching nursing home. She is a member... Read More →



Thursday March 22, 2018 8:00am - 11:30am MST
Texas 3-4
  Clinical Medicine

8:00am MST

TH4 | Telemedicine in PA/LTC: How to do it and do it Well
Telemedicine is rapidly becoming a standard of care in modern medicine. By increasing access and responsiveness to care, telemedicine can improve clinical outcomes, reduce costs, and increase provider, patient, and family satisfaction. Despite these potential benefits, the technology and the requisite changes that it brings are relatively new in the PA/LTC setting. Many health care providers and leaders have expressed the need to build their knowledge and skills to reap the full potential value of this innovation. This half-day workshop will build attendee’s knowledge and skills in the standards for telemedicine care in PA/LTC through engaging lectures, roundtable interactive examples of telemedicine from PA/LTC settings, and facilitated discussions. Learners will leave with practical skills that are needed to “get started,” to advanced skills such as making the financial case for telemedicine in their PA/LTC system, to ensure that their program has the care processes and technology to accomplish their goals.

Learning Objectives:
(1) Discuss the opportunities to use telemedicine to enhance PA/LTC.
(2) Identify technical and environmental considerations for high quality telemedicine in PA/LTC.
(3) Develop a strategy for establishing telemedicine services in their practice or medical group.

Speakers
avatar for Suzanne Gillespie, MD, RD, CMD

Suzanne Gillespie, MD, RD, CMD

Suzanne Gillespie MD, RD, CMD, is Associate Professor of Medicine in the Division of Geriatrics/Aging and Associate Professor of Emergency Medicine at the University of Rochester School of Medicine and Dentistry. She is board-certified in Internal Medicine, Geriatric Medicine and... Read More →


Thursday March 22, 2018 8:00am - 11:30am MST
Texas 5-6
  Clinical Medicine

8:00am MST

TH7 | Non-Pharmacologic Interventions for Persons With Dementia in Residential Care: Strategies for Implementing Cognitive Stimulation Therapy
This session will introduce participants to evidence-based, non-pharmacologic interventions that will expand knowledge and competence regarding strategies to address behavioral symptoms in persons with dementia and improve quality of life. Through three presentations, the interactive session will highlight non-pharmacologic interventions appropriate for the LTC setting with specific strategies for implementation of one, Cognitive Stimulation Therapy (CST), into the residential environment. The first presentation focuses on the evidence and options for interprofessional non-pharmacologic interventions with specific attention being devoted to Reminiscence Therapy, Validation Therapy, and Reality Orientation. The second and third presentations will focus on a well-researched non-pharmacologic intervention, Cognitive Stimulation Therapy (CST) which can be delivered by residential staff at multiple levels of clinical training to address behavioral symptoms and issues in persons with dementia.

Learning Objectives:
(1) Discuss the evidence for non-pharmacologic interventions for persons with dementia.
(2) Describe criteria for appropriateness to receive non-pharmacologic interventions for persons with dementia.
(3) Apply knowledge and skills gained to introduce Cognitive Stimulation Therapy within the residential care setting.
(4) Implement strategies for integration and evaluation of Cognitive Stimulation Therapy.


Thursday March 22, 2018 8:00am - 11:30am MST
San Antonio 5-6
  Clinical Medicine

8:00am MST

TH5 | The Practical Application of MDS (Minimum Data Set) and Other Available Data to Improve Site-Specific Quality Measure Performance
This session will present novel approaches to using a skilled nursing facility's own quality measure data to engage its medical director, unify its healthcare team, and improve quality measure performance.

Learning Objectives:
(1) Determine how to use their Quality Measure data to engage the leadership and accountability of their Medical Director.
(2) Describe novel methods for creating high impact presentations of Quality Measure data.
(3) Use a SNF's Quality Measure data to unify their healthcare team and motivate improved performance.
(4) DIcuss the value of trending, tracking, and visualizing their Quality Measure data as a means to improve Quality Measure scores.

Speakers
avatar for Kevin O'Neil, MD, CMD

Kevin O'Neil, MD, CMD

Kevin O’Neil, MD, FACP, is the Chief Medical Officer for Ascension Senior Living. He was formerly the Chief Medical Officer at Brookdale Senior Living (BSL) from 2006 until October 2016. Dr. O’Neil is a Clinical Professor in the Department of Aging Studies at the University of... Read More →


Thursday March 22, 2018 8:00am - 11:30am MST
Dallas 5-6
  Medical Direction

8:00am MST

TH1 | Basics of Value-Based Practice (VBP), Program Models, and Clinical Strategies for Success
In this session readmissions, length of stay (LOS), advance care planning, and patient/family education will be presented with strategies for positive individual clinician and group practice outcomes/performance. The speakers will discuss provider actions that “influence a good discharge” and the concept of “discharge planning beginning on admission.” This session will explore use of facility resources and home health nursing and provider/practice behaviors that influence positive partnerships with facilities and partners.

Learning Objectives:
(1) Describe general concepts of Value Based Purchasing Models and alterations in clinical practice and workflow to ensure success in participation.
(2) Explain the concepts of risk-bearing within VBP models, as well as metrics utilized, data collection, and reporting options.
(3) Discuss the role and Management of Readmission Rates, Advance Directives, and Length of Stay in VBP strategies.
(4) Recognize the importance of Medication Optimization, Facility Partnering, and use of Available Resources in VBP Strategies.

Speakers
avatar for Charles Crecelius, MD, PhD, CMD

Charles Crecelius, MD, PhD, CMD

Charles Crecelius, MD, CMD, PhD, is currently the medical director at Willowbrook Medical Center. He is the immediate past chair of AMDA’s Public Policy Committee and is a Past President of AMDA among his many other leadership positions within the organization.


Thursday March 22, 2018 8:00am - 11:30am MST
Texas D
  Practice Management

8:00am MST

TH6 | Medical CME Question-Writing Workshop: Focus on Medical Direction and Attending Physicians' Skills, Knowledge, and Abilities in PA/LTC
The workshop will cover principles for writing CME questions, suggestions for writing realistic and practical questions at the appropriate cognitive level, and question writing exercises. Experts will have the chance to not only develop questions, but receive instant feedback on how well their questions match industry standards, allowing them to edit their questions and have them accepted at the workshop. The workshop will allow subject matter experts the opportunity to learn cross-field question-writing principles which will allow them to write valid questions in a multitude of professional and educational settings.

This workshop requires pre-registration to participate. If you are interested in attending or would like more information about this opportunity, please contact Suzanne Harris, Director of American Board of Post-Acute and Long-Term Care Medicine (ABPLM), at cmd@paltc.org by March 21, 2018. Participants will need to bring a laptop to participate in the workshop.

Learning Objectives:
(1) Construct MCQs that can measure knowledge, recall, application and analysis.
(2) Use strategies to avoid technical flaws in question-writing and common question-writing pitfalls.
(3) Apply question-writing principles to add to PA/LTC CME question bank.

Thursday March 22, 2018 8:00am - 11:30am MST
Dallas 7
  Professional Development

8:00am MST

INF1 | SHEA/CDC/AMDA Infection Prevention in PA/LTC Certificate Course
This certificate course will address aspects of infection prevention that are unique to skilled nursing facilities, where residents share dining, recreation, and rehabilitation experiences. The course will review occupational health concerns in PA/LTC, including outbreaks, those that affect both staff and residents, and also emphasize opportunities to reduce unnecessary and inappropriate antimicrobial use. Speakers will specifically discuss communication at care transitions and ways to talk with concerned family members, who may have been taught myths and misinformation.

Learning Objectives:
(1) Describe surveillance definitions and recognize differences in applying them in the PA/LTC settings.
(2) Identify opportunities for infection prevention, including those caused by multi-drug resistant organisms, in the PA/LTC settings.
(3) Discuss recognition and response to common outbreaks in the PA/LTC settings.
(4) Apply principles of occupational health and safety to healthcare workers and staff in the PA/LTC settings.

Thursday March 22, 2018 8:00am - 5:00pm MST
Grapevine B
  Clinical Medicine

11:30am MST

PSTR | Poster Session Opens
The Scientific Posters may be viewed from 11:30 AM Thursday, March 22 through 7:00 PM Friday, March 23. Poster presenters will be on hand to answer questions on Thursday evening from 5:00 PM to 7:00 PM. Attendees who view the posters may claim up to 1 AMA PRA Category 1 Credit™.

Thursday March 22, 2018 11:30am - 12:30pm MST
TBA

1:30pm MST

TH11 | Serious Illness Conversation, Evidence-Based Techniques for LTC Clinicians
This session will review the components of the Serious Illness Program, an evidence-based, patient tested, structured approach to serious illness conversation. Participants will practice using the serious illness conversation guide and will receive feedback and advice for implementing the technique in patient care.

Learning Objectives:
(1) Recognize the need for a systematic evidence-based approach to discussing goals and values with seriously ill patients.
(2) Describe the seven steps of the Serious Illness Conversation.
(3) Demonstrate use of the Serious Illness Communication Guide to elicit preferences and patient goals of care.
(4) Provide feedback related to observed skills/techniques that facilitate exploratory conversations with patients and family members.

Speakers
avatar for Kevin Henning, MD, CMD

Kevin Henning, MD, CMD

Kevin Henning, MD, CMD, is a family physician and serves as Medical Director, Optum CarePlus for the state of Washington. He is board-certified in family practice and hospice and palliative medicine and a certified medical director with the American Medical Directors Association... Read More →


Thursday March 22, 2018 1:30pm - 5:00pm MST
Texas 5-6
  Clinical Medicine

1:30pm MST

TH9 | Demystifying the Basic Metabolic Panel
This interactive, case-based session will engage participants in problem solving commonly reported electrolyte abnormalities encountered in LTC. The cornerstones of understanding altered physiology, astute clinical assessment, and application of logical diagnostic and therapeutic strategies will be highlighted.

Learning Objectives:
(1) Interpret the BMP accurately, Diagnose and manage hyponatremia and hypernatremia.
(2) Identify causes work up and treatment of hyperkalemia and hypokalemia and acid base imbalance.
(3) Describe the differential diagnosis of hypercalcemia and hypocalcemia and appropriate management.

Speakers
avatar for Naushira Pandya, MD, CMD

Naushira Pandya, MD, CMD

Naushira Pandya, MD, CMD, is a board certified geriatrician internist as well as endocrinologist. She is chair of the Geriatrics department and directs the recently federally funded Geriatrics Education Center at Nova Southeastern University College of Osteopathic Medicine. She is... Read More →
avatar for Meenakshi Patel, MD, MMM, CMD

Meenakshi Patel, MD, MMM, CMD

Meenakshi Patel, MD, MMM, CMD, is a board certified geriatrician internist and a multi-facility medical director. She has an active medical practice in Centerville, OH as well as a research program. She has been a member of the AMDA Board of Directors, and several key AMDA committees... Read More →


Thursday March 22, 2018 1:30pm - 5:00pm MST
Texas 1-2
  Clinical Medicine

1:30pm MST

TH12 | Unleash the Power of Performance Improvement in Your Facility by Stopping the Madness of Data Insanity
Never before have PA/LTC facilities been held more accountable or more scrutinized internally as well as publicly. Yet, many facilities have little or no experience in analyzing data. Using data to identify, and impact, areas of performance improvement is a major function of quality assurance and performance improved (QAPI) success. Unfortunately, staff get stuck wasting time, and money, comparing this month’s measures to numbers last month or last quarter, because they don’t know what to do differently. This session is going to be an eye-opening, no holds barred expose of what we are doing wrong with data and how to make it right. We will delve deeper into the data facets of QAPI using real facility examples to demonstrate how to use data for sustainable process improvement. This will be an interactive session with participation opportunities and clear guidance on strategies for change. It’s time we solve long-standing problems in our facilities for good, and for the greater good.

Learning Objectives:
(1) Recognize the futility and unintended misleading effects of common analyses like bar graphs, trend lines, rankings, and benchmarking and more importantly, what to do differently.
(2) Demonstrate how process-oriented thinking is crucial to every improvement effort.
(3) Explain common cause and special cause variation, and how this knowledge will transform improvement efforts.
(4) Discuss how to choose the right improvement strategy based on the type of variation identified.

Speakers
avatar for Leonard Gelman, MD, CMD

Leonard Gelman, MD, CMD

Leonard Gelman, MD, CMD, has been in private medical practice in the Capital District area of New York for 30 years. He has been an attending physician and medical director for many facilities over these years. He is a member of AMDA and has been on the AMDA Board of Directors most... Read More →
avatar for Paige Hector, LMSW

Paige Hector, LMSW

Paige Hector, LMSW, is a clinical educator with over 25 years’ health care experience. Ms. Hector gives workshops and seminars across the country on diverse topics related to post-acute and long-term care. Published in 2016, she authored two chapters for a textbook titled Managing... Read More →


Thursday March 22, 2018 1:30pm - 5:00pm MST
Dallas 5-6
  Medical Direction

1:30pm MST

TH13 | Thinking Right and Acting Right: How Medical Directors can Lead the Way in Nursing Facility Improvement
This session will present a comprehensive approach to nursing home improvement based on key clinical and management principles, focusing on clinical reasoning. The presenters are jointly responsible for overseeing approximately 60 facilities across multiple states as regional medical directors. In collaboration with those of other key disciplines, they have conceived, developed, and implemented a program that cuts across all measures and topics. The “Thinking Right and Acting Right” program, based on clinical reasoning and across-the-board accountability, has been deployed successfully across multiple facilities and in multiple states. This session will show in detail how this common approach has led to multiple desirable outcomes including sustained improvement in care, improvement in diverse quality measures, better regulatory survey outcomes, more effective medical practitioner roles, and a general strengthening of facility processes and systems. The session will show in detail how medical directors can provide leadership for comprehensive, facility-wide improvement of care and performance in nursing homes. Actual cases and data will be presented to show how this common approach is sustainable and reproducible across settings, and can be understood and applied by those of all disciplines, not just medical practitioners.

Learning Objectives:
(1) Identify key clinical and management principles for meaningful and sustained improvement in a nursing home's care and performance.
(2) Discuss the critical role of medical directors in leading a nursing home to analyze and improve its entire approach to care.
(3) Identify and address in meaningful ways challenges to improvement including the major impact of cognitive biases on care quality.
(4) Implement meaningful, sustained improvement in a nursing facility using efficient and effective clinical and management strategies.

Speakers
avatar for Steven Levenson, MD, CMD

Steven Levenson, MD, CMD

Steven Levenson MD, CMD, is the Regional Medical Director for Kentucky and Tennessee for Genesis Healthcare, as well as a facility medical director and attending physician for several facilities in Maryland. He is the author of various publications on medical direction and has helped... Read More →
avatar for Jean Storm, DO

Jean Storm, DO

Jean Storm, DO, has worked for Genesis Healthcare since 2013 and is currently the Regional Medical Director for West Virginia for Genesis, as well as a facility medical director and attending physician for several facilities in the state. She is a 2001 graduate of the Erie College... Read More →


Thursday March 22, 2018 1:30pm - 5:00pm MST
San Antonio 5-6
  Medical Direction

1:30pm MST

TH10 | An Evolution in Transitions: Improving the Skilled Nursing Facility and Emergency Department Relationship
This session will lay the foundation for understanding, appreciating, and improving the compromised relationship that has existed between the emergency room and the skilled nursing facility. Experts from the American College of Emergency Physicians (ACEP) and AMDA – The Society for Post-Acute and Long-Term Care Medicine will describe the current state of affairs and how these two institutions can begin to work together in a meaningful and collaborative way as advocates for their mutual patients, based on enhanced communication, education, and the recognition of common goals.

Learning Objectives:
(1) Describe the challenges that exist in the transitions of care environment that act to compromise a purposeful relationship between the skilled nursing facility (SNF) and emergency department (ED).
(2) Realize how the ED, through the work of ACEP, is understanding how it needs to re-define itself in it's care of patients and it's relationship to PA/LTC providers,
(3) Consider how "best practices" in transitioning patients between the ED and SNF can be implemented in both locales
(4) Appreciate how the "geriatric" emergency room can augment the care of patients and positively impact Population Health programs and the Triple Aim.

Speakers
avatar for Wayne Saltsman, MD, PhD, CMD

Wayne Saltsman, MD, PhD, CMD

Wayne Saltsman, MD, CMD, PhD, completed a clinical fellowship in Geriatric medicine at Harvard Medical School and is board-certified in Internal Medicine, Geriatric medicine, and Hospice and Palliative medicine. He is an assistant professor of Medicine at Tufts medical school, and... Read More →


Thursday March 22, 2018 1:30pm - 5:00pm MST
Texas 3-4
  Models of Care

1:30pm MST

TH8 | Managing Quality Reporting in PA/LTC Medicine: Strategies for Selecting, Capturing, and Reporting Quality Metrics in Your Practice
Quality measures are the largest determinant of your 'value' under all Medicare/Medicaid programs. Beginning with 2017, they determine how all physicians, APNs, and PAs are 'rated'. Those ratings follow you across all employment settings. Understanding how to manage your quality scores is becoming professionally critical. Each practitioner can be enrolled in multiple programs with different reporting requirements. You'll learn about managing quality for different audiences, reporting for regulatory purposes (CMS), and how to improve shared-patient care. This program is designed for clinical and administrative leaders with responsibility for quality reporting and quality strategies.

Learning Objectives:
(1) Select a menu of MIPS Quality Measures that are likely to yield better scores in 2018.
(2) Describe the design of the quality metrics through the APM model, and how to participate.
(3) Discuss how do practices contribute to I-SNP quality?
(4) Identify how AMDA members can redefine PAC and LTC quality that's appropriate for patients, the practitioner, partners, and payors.

Speakers
avatar for Dheeraj Mahajan, MD, CMD

Dheeraj Mahajan, MD, CMD

Dheeraj Mahajan, MD, CMD, CIC, is currently the President and CEO of CIMPAR, S.C. (Chicago Internal Medicine Practice and Research). He also holds an academic appointment as the Clinical Assistant Professor of Medicine, University of Chicago, Illinois. In addition to being President... Read More →
avatar for Kerry Weiner, MD, MPH

Kerry Weiner, MD, MPH

Kerry Weiner, MD, MPH, is currently the Chief Medical Officer for IPC-The Hospitalist Company, Inc. (Nasdaq:IPCM), a leading national physician group practice company. In his role, Dr. Weiner is responsible for the ongoing development of leadership skills for IPC's 1,400 hospital... Read More →
avatar for Alex Bardakh, MPP

Alex Bardakh, MPP

Alex Bardakh, MPP, PLC, is the Director of Public Policy & Advocacy for AMDA – The Society for Post-Acute and Long-Term Care Medicine. Alex is a tireless worker for the Society’s extensive Public Policy agenda through Advocacy in Congress and numerous Federal Agencies. A graduate... Read More →
avatar for Rod Baird, MS

Rod Baird, MS

William “Rod” Baird, MS, has experience that includes 35+ years of LTC Physician and Provider management. He is currently President of GPM, the developer of gEHRiMed™, a Stage 2 ONC certified ambulatory EHR for LTPAC Physicians. Until 2014, he was the President of Extended Care... Read More →


Thursday March 22, 2018 1:30pm - 5:00pm MST
Texas D
  Practice Management
 
Friday, March 23
 

8:00am MST

FR1 | General Session I
Opening of the Society’s 2018 Annual Conference
Mary Evans, MD, CMD, Annual Conference Planning Subcommittee Chair; Christopher Laxton, CAE, Society Executive Director; Heidi White, MD, MPH, CMD, Society President

Award Presentations:
Medical Director of the Year Award
James Pattee Excellence in Education Award
William Dodd Founder’s Award

AMDA Foundation Update and Quality Improvement Awards
Barbara Resnick, PhD, CRNP, Society’s Foundation Chair

American Board of Post-Acute and Long-Term Care Medicine (ABPLM) Update
Thomas Edmondson, MD, CMD, ABPLM Chair

Keynote Address
Cheryl Phillips, MD, CMDR


Speakers
avatar for Christopher Laxton, CAE

Christopher Laxton, CAE

Christopher Laxton, CAE, is a career association professional with over 30 years of experience in nonprofit leadership, governance and operations and has been the Executive Director of AMDA since February 2013.
avatar for Thomas Edmondson, MD, CMD

Thomas Edmondson, MD, CMD

Tom Edmondson, MD, CMD, AGSF, FACP is a geriatrician in the Baltimore region and currently serves as Chair of the American Board of Post-Acute and Long-Term Care Medicine. He is president of MMDA--The Mid-Atlantic Society for Post-Acute and Long Term Care Medicine, and he serves on... Read More →
avatar for Mary Evans, MD, CMD

Mary Evans, MD, CMD

Mary Evans, MD, CMD, started a LTC practice eleven years ago, has worked as an attending physician and medical director for several years before being recruited by Golden Living as a Regional Medical Director. Her current position is as Compliance Executive Physician at Golden Living... Read More →
avatar for Cheryl Phillips, MD, CMDR

Cheryl Phillips, MD, CMDR

Cheryl Phillips, MD, CMDR, is the Senior Vice President of Public Policy for LeadingAge, the national organization of non-profit aging service providers. She has extensive clinical and leadership experience in PAC and home and community based services, as well as managed care and... Read More →


Friday March 23, 2018 8:00am - 10:30am MST
TBA
  General Session

11:00am MST

FR5 | Apathy: Treating What can be Overlooked in LTC Facilities
Apathy is a common disorder, but can be easily overlooked. Treatment requires multidisciplinary approaches based on the understanding of apathy from the biomedical, psychological, and socio environmental aspects. This session reviews the definition of apathy, its effects, physiological implications, and approaches used to detect, treat, and manage elderly patients experiencing apathy in LTC facilities. The goal of this session is to increase the recognition of apathy and enhance the role and functions of the interdisciplinary team caring for patients dealing with apathy in LTC facilities.

Learning Objectives:
(1) Define, and discuss the diagnostic criteria and effects of Apathy on patients in LTC facilities.
(2) Describe the physiological implications of Apathy: Differential Diagnosis, Frontotemporal Dementia and Apathy.
(3) Discuss approaches and demonstrate the use of screening tools used to detect, treat and manage patients experiencing apathy in LTC facilities.
(4) Demonstrate strategies to foster effective communication, role and functions of the interdisciplinary team, patients, families and caregivers.


Friday March 23, 2018 11:00am - 12:00pm MST
Dallas 5-6
  Clinical Medicine

11:00am MST

FR8 | Parkinson's Disease: A Video is Worth 1.8 Million Words
If a picture is worth 1,000 words and video shoots at 30 frames per second, every second of video is worth 30,000 words and a whole minute of video could be worth 1.8 million words. Regardless of the metrics, videos are an excellent tool for showing some of the many highly variable presentations of common issues associated with Parkinson's, especially motor manifestations such as tremor, bradykinesia and freezing of gait. During this session, the presenters will make extensive use of video to highlight presentations of common phenomena associated with Parkinson's over the course of the disease. When available, videos will demonstrate similar phenomena at early and later stages to help illuminate how common symptoms such as tremor and gait deficits change over time. Additional video will demonstrate possible compensatory approaches for difficult to treat issues such as freezing of gait and swallowing issues as well as the significant gains that can be achieved by the simple speech and physical therapy approaches to many issues. All topics, however, will be accompanied by a discussion of both pharmacological and nonpharmacological treatment approaches.

Learning Objectives:
(1) Recognize key components of primary motor symptoms of Parkinson's, tremor, rigidity, akinesia/bradykinesia and postural instability.
(2) Highlight potential complications of dopaminergic therapy, including dyskinesias, motor fluctuations and off-period symptomatology.
(3) Implement strategies to address freezing of gait.
(4) Identify manifestations of voice and swallowing issues associated with Parkinson's and possible treatment approaches.

Speakers
avatar for John Dean, MA, CCC-SLP

John Dean, MA, CCC-SLP

John Dean, MA, CCC-SLP, is a speech language pathologist specializing in the treatment of Parkinson's and related disorders. He serves on the faculty of the Allied Team Training Program (ATTP) and is active within the International Parkinson's Movement Disorder Society as well as... Read More →
avatar for Nora Reznickova, MD

Nora Reznickova, MD

Nora Reznickova, MD, is geriatrician and palliative care physician, serving elderly individuals in post-acute care, long-term care and assisted living facilities in the metro Denver area. She has witnessed many of the gaps in care for people with Parkinson's disease as a medical provider... Read More →


Friday March 23, 2018 11:00am - 12:00pm MST
San Antonio 4
  Clinical Medicine

11:00am MST

INF1 | SHEA/CDC/AMDA Infection Prevention in PA/LTC Certificate Course Cont.
This certificate course will address aspects of infection prevention that are unique to skilled nursing facilities, where residents share dining, recreation, and rehabilitation experiences. The course will review occupational health concerns in PA/LTC, including outbreaks, those that affect both staff and residents, and also emphasize opportunities to reduce unnecessary and inappropriate antimicrobial use. Speakers will specifically discuss communication at care transitions and ways to talk with concerned family members, who may have been taught myths and misinformation.<br /> <br /> Learning Objectives:<br /> (1) Describe surveillance definitions and recognize differences in applying them in the PA/LTC settings. <br /> (2) Identify opportunities for infection prevention, including those caused by multi-drug resistant organisms, in the PA/LTC settings. <br /> (3) Discuss recognition and response to common outbreaks in the PA/LTC settings. <br /> (4) Apply principles of occupational health and safety to healthcare workers and staff in the PA/LTC settings.

Friday March 23, 2018 11:00am - 12:00pm MST
Grapevine B
  Clinical Medicine

11:00am MST

FR2 | Are we Doing Enough? A Need for New Approaches to Address Transitions of Care for the Older Adults Across Continuum of Care
This session will discuss key factors leading to ineffective care transitions, emphasize the need for a new approach to delivering transitional care, and describe an integrated approach to achieve optimal transitional care. This approach is based on best practices of different models of care transitions and has not been implemented yet. It has seven key elements based on factors that can help achieve effective care transitions: (1) effective communication among providers; (2) discussion of goals of care and advance directives; (3) functional assessment; (4) medication reconciliation; (5) co-ordination and effective implementation of a care plan; (6) timely and quality discharge summaries; (7) patient-centered instructions and risk-related education.

Learning Objectives:
(1) Implement key elements of an effective care transitions into patient care.
(2) Establish strong communication and collaboration with community physicians, and hospital, and home care teams to provide optimal patient care during care transitions.
(3) Implement strategies for effective communication with patients, families and care teams during care transitions.


Friday March 23, 2018 11:00am - 12:00pm MST
Texas 1-2
  Models of Care

11:00am MST

FR3 | Care of the Actively Dying
This session will discuss the special care needs of the actively dying resident, the special care needs of those in the last few hours to days of life, and review the barriers to meeting those needs. An interdisciplinary protocol developed at the Gouverneur Skilled Nursing Facility will be presented as an example of a successful model to overcome these barriers.

Learning Objectives:
(1) Identify four common physical findings associated with active dying.
(2) Recognize five common institutional barriers to provision of optimal care for the actively dying.
(3) Strategize solutions to overcome these barriers in their institutions.
(4) Recognize how the actively dying phase may affect the care planning for different members of the interdisciplinary team.

Friday March 23, 2018 11:00am - 12:00pm MST
Texas 3-4
  Models of Care

11:00am MST

FR10 | Apples to Apples: A Review of AMDA's Efforts in Defining Meaningful Quality Measures for Practitioners in PA/LTC
The session will review the history of physician quality reporting programs (PQRI -> PQRS -> VBM -> MACRA) and the Society’s current MIPS quality measure list. The presenters will discuss the Society’s work with the National Quality Forum Incubator Challenge as well as the Society’s discussion with the Centers for Medicare & Medicaid leadership during their "Spotlight Series" that provided the Society the opportunity to highlight the need for quality measures for the PA/LTC practitioner. Finally, the session will review current Society efforts to secure funding for quality measure development.

Learning Objectives:
(1) Review history of quality measure development and progression of various quality payment programs.
(2) Discuss how practitioners in PA/LTC currently report quality measures.
(3) Describe AMDA's Quality Measure Committee's efforts to identify meaningful measures in PA/LTC.
(4) Elaborate AMDA's plans to develop meaningful measures and reporting mechanisms using private and public partnerships.

Speakers
avatar for Dheeraj Mahajan, MD, CMD

Dheeraj Mahajan, MD, CMD

Dheeraj Mahajan, MD, CMD, CIC, is currently the President and CEO of CIMPAR, S.C. (Chicago Internal Medicine Practice and Research). He also holds an academic appointment as the Clinical Assistant Professor of Medicine, University of Chicago, Illinois. In addition to being President... Read More →
avatar for Alex Bardakh, MPP

Alex Bardakh, MPP

Alex Bardakh, MPP, PLC, is the Director of Public Policy & Advocacy for AMDA – The Society for Post-Acute and Long-Term Care Medicine. Alex is a tireless worker for the Society’s extensive Public Policy agenda through Advocacy in Congress and numerous Federal Agencies. A graduate... Read More →


Friday March 23, 2018 11:00am - 12:00pm MST
Texas Ballroom C
  Practice Management

11:00am MST

FR4 | Enhancing Leadership for Women in PA/LTC: The Magic of Mentorship
Building on feedback from attendees at the 2017 Annual Conference and recent literature, this session will focus on mentorship for those working with PA/LTC teams and administration. Effective mentorship is critical to the success of all health care professionals, but especially those in leadership positions. Mentorship is a two-way street. Being an effective, thoughtful mentor is challenging, and so is being a proactive, engaged mentee. This session will offer brief didactics on mentorship. Interactive and facilitated roundtables will help attendees develop skills for establishing and sustaining meaningful mentoring relationships. The session will also offer attendees opportunities to build their professional network.

Learning Objectives:
(1) Discuss the importance of mentoring relationships on professional development.
(2) Create a personal action plan to engage mentors in their own institution or those mentors encountered on a national level.
(3) Identify strategies to promote effective, successful mentoring relationships.

Speakers
avatar for Suzanne Gillespie, MD, RD, CMD

Suzanne Gillespie, MD, RD, CMD

Suzanne Gillespie MD, RD, CMD, is Associate Professor of Medicine in the Division of Geriatrics/Aging and Associate Professor of Emergency Medicine at the University of Rochester School of Medicine and Dentistry. She is board-certified in Internal Medicine, Geriatric Medicine and... Read More →


Friday March 23, 2018 11:00am - 12:00pm MST
Texas 5-6
  Professional Development

11:00am MST

FR9 | Breaking Science: Presentations from Leading Researchers in PA/LTC Medicine
The session will highlight the latest scientific evidence through a series of brief oral presentations from leading researchers in the field of PA/LTC medicine. 10 minute oral presentations will be followed by a 5 minute dialogue between the audience and speakers.

Learning Objectives:
(1) Describe recent research studies conducted in the PA/LTC settings.
(2) Disseminate research results and conclusions with peers in the PA/LTC field.
(3) Direct clarifying questions to researchers about studies performed in PA/LTC settings.

Speakers
avatar for Julie Gammack, MD, CMD

Julie Gammack, MD, CMD

Julie Gammack, MD, CMD, is a Professor of Medicine at St. Louis University School of Medicine. She is the Associate Dean for Graduate Medical Education, past Program Director for the Geriatric Medicine Fellowship, and a Medical Director at a teaching nursing home. She is a member... Read More →
avatar for Michelle Bellantoni, MD, CMD

Michelle Bellantoni, MD, CMD

Michele Bellantoni, MD, CMD, is an Associate Professor in the Department of Medicine at the Johns Hopkins University School of Medicine. She is the Clinical Director of the Division of Geriatric Medicine and Gerontology, and Medical Director of the Specialty Hospital Programs, at... Read More →


Friday March 23, 2018 11:00am - 12:00pm MST
San Antonio 5-6
  Research

1:30pm MST

FR15 | Navigating the Turbulent Waters of Wound Care
This session will provide an update on the current practice guidelines and recommendations for delivery of wound care in the post-acute setting. Various etiologies, assessment, and treatments will be discussed. Additionally, information on the development of a wound care team and establishing a center of excellence in wound management will be addressed.

Learning Objectives:
(1) Understand various wound types and classifications.
(2) Recognize the importance of correct etiology identification.
(3) Identify various roles of the wound care team.

Speakers
avatar for Karl Steinberg, MD, CMD

Karl Steinberg, MD, CMD

Karl Steinberg, MD, CMD, has been a nursing home and hospice medical director, attending physician and educator in San Diego for over 20 years and is editor-in-chief of Caring for the Ages in addition to serving on AMDA's Board of Directors and multiple committees. He is a frequent... Read More →
avatar for Shark Bird, MD, CMD

Shark Bird, MD, CMD

Shark Bird, MD, CMD, has been practicing post acute medicine since completion of his residency in 1996. In addition, he has served on multiple missions in Benin, West Africa at the Hospital Evangelique a Bembereke. He has been practicing in wound care full time since 2004 and currently... Read More →
avatar for Scott Bolhack, MD, MBA, CMD

Scott Bolhack, MD, MBA, CMD

Scott Bolhack, MD, CMD, speaks nationally on the subject of wound care, palliative care and hospice, rehabilitation in nursing homes, and quality improvement processes. Dr. Bolhack has additional experience as a medical director for wound centers, nursing homes, assisted living facilities... Read More →


Friday March 23, 2018 1:30pm - 3:00pm MST
Austin 4-6
  Clinical Medicine

1:30pm MST

INF1 | SHEA/CDC/AMDA Infection Prevention in PA/LTC Certificate Course Cont.
This certificate course will address aspects of infection prevention that are unique to skilled nursing facilities, where residents share dining, recreation, and rehabilitation experiences. The course will review occupational health concerns in PA/LTC, including outbreaks, those that affect both staff and residents, and also emphasize opportunities to reduce unnecessary and inappropriate antimicrobial use. Speakers will specifically discuss communication at care transitions and ways to talk with concerned family members, who may have been taught myths and misinformation.<br /> <br /> Learning Objectives:<br /> (1) Describe surveillance definitions and recognize differences in applying them in the PA/LTC settings. <br /> (2) Identify opportunities for infection prevention, including those caused by multi-drug resistant organisms, in the PA/LTC settings. <br /> (3) Discuss recognition and response to common outbreaks in the PA/LTC settings. <br /> (4) Apply principles of occupational health and safety to healthcare workers and staff in the PA/LTC settings.

Friday March 23, 2018 1:30pm - 3:00pm MST
Grapevine B
  Clinical Medicine

1:30pm MST

FR12 | Demonstrating Improvement in Pain Management Through a Novel, International Collaborative Approach to QI
This session will present the results of a 2-year improvement project to improve pain management for LTC residents among 12 senior care organizations in Canada and the United States. Beginning in January 2014, the Seniors Quality Leap Initiative (SQLI) initiated an improvement project to improve site and average performance on a number of quality improvement measures related to pain in LTC. Using the evidence-based InterRAI Clinical Assessment Protocol (CAP) for pain as well as the Registered Nurses Association of Ontario (RNAO) best practice guideline for pain, the SQLI developed a method to conduct an in-depth gap analysis based on best practice to develop an improvement plan based on individual gaps. This novel, collaborative approach is the first of its kind in the long-term care sector.

Learning Objectives:
(1) Define the organizational based interventions that have shown to lead to significant improvement in quality measures related to pain in LTC in both Canada and the US.
(2) Describe the best practice approaches to pain management in post-acute and LTC,
(3) Describe the elements of the gap analysis and how it can be applied other quality improvement projects in the LTC sector.
(4) Identify strategies, resources and supports necessary to drive change and success and the impact of this quality improvement approach on LTC policy.

Speakers
avatar for Paul Katz, MD, CMD

Paul Katz, MD, CMD

Paul Katz, MD, CMD, is Professor of Medicine and Director of the Department of Geriatric Medicine, Florida State University, and a Past President of the American Medical Director's Association. He is the lead physician of the Working Committee of the Seniors Quality Leap Initiative... Read More →


Friday March 23, 2018 1:30pm - 3:00pm MST
Texas 3-4
  Models of Care

1:30pm MST

FR13 | Drugs, Sex and Rock 'N Roll: Changing Times in LTC
The purpose of this session is to present a diverse panel of experts who will discuss the development of programs, policies, and clinical interventions at the Hebrew Home at Riverdale involving sexual expression and medical marijuana. This is a very unique opportunity for conference attendees to gain the perspectives of a CEO, CMD, and LTC consulting attorney in a fascinating 90-minute session that should not be missed.

Learning Objectives:
(1) Describe three novel programs at the Hebrew Home of Riverdale which may be used as models for change in participant facilities.
(2) Discuss strengths and limitations to use of medical marijuana in LTC.
(3) Review current or pending legislation which may impact the use of medical marijuana in LTC.
(4) Discuss leadership skills which facilitate change in the LTC environment.

Speakers
avatar for Alan Horowitz, JD, RN

Alan Horowitz, JD, RN

Alan Horowitz, JD, RN, is a partner in the firm of Arnall, Golden, Gregory, LLP, and has specialized in legal matters related to nursing homes for the past 25 years. Mr. Horowitz previously served as counsel for CMS and now provides defense counsel for nursing homes and LTC provi... Read More →


Friday March 23, 2018 1:30pm - 3:00pm MST
Texas 5-6
  Models of Care

1:30pm MST

FR16 | Antibiotic Stewardship in PA/LTC Facilities: Evidence-Based Approach on Starting and Sustaining a Successful Program
This session will provide guidance on starting and sustaining an antibiotic stewardship program (ASP) in their facilities. This will be achieved by introducing the core elements that are essential to a successful ASP. The presenters will provide practical tips on implementing all the core elements using easily available free resources. The audience will also have the opportunity to interact with experts, including those who are currently helping various LTC facilities in developing their own ASP. The ultimate goal of this session is to prepare medical directors, other clinical practitioners, and nursing home administrators for implementing a sustainable ASP at their facilities, based on the Centers for Disease Control and Prevention (CDC) recommended core elements.

Learning Objectives:
(1) Describe core elements of an antibiotic stewardship program and the related CMS regulations.
(2) Discuss the need for implementing antibiotic stewardship program with all seven CDC recommended core elements and the role of medical director in the implementation.
(3) Demonstrate practical steps that can be taken to implement each element of antibiotic stewardship program using easily available resources.
(4) Review the available resources needed to successfully start and sustain an antibiotic stewardship program.

Speakers
avatar for Dheeraj Mahajan, MD, CMD

Dheeraj Mahajan, MD, CMD

Dheeraj Mahajan, MD, CMD, CIC, is currently the President and CEO of CIMPAR, S.C. (Chicago Internal Medicine Practice and Research). He also holds an academic appointment as the Clinical Assistant Professor of Medicine, University of Chicago, Illinois. In addition to being President... Read More →
avatar for Elizabeth Frentzel, MPH

Elizabeth Frentzel, MPH

Elizabeth Frentzel, MPH, is a Principal Research Scientist in the Effective, Efficient, and Patient-Centered Health Care Program at the American Institutes for Research. She is a member of the Infection Control Sub-Committee of AMDA-The Society for Post-Acute and Long-Term Care Medicine... Read More →


Friday March 23, 2018 1:30pm - 3:00pm MST
Ft. Worth 5-7
  Models of Care

1:30pm MST

FR17 | New Approaches to Healthcare: How Society Plans to Facilitate Innovative Experimentation
Health care is changing fast and no setting is being affected more than the PA/LTC setting. Stakeholders are demanding high quality, and so are patients and their families. In the context of these changes and funding constraints, the value of innovation and implementation has been amplified. Last year, the Society conducted an Innovations Forum that provided members a platform to voice their ideas around the Society's role in PA/LTC innovations. The message was clear: the Society needs to be the leader in PA/LTC innovation and change. In response, the Board of Directors nominated the Innovations Platform Advisory Committee (IPAC) that consists of clinicians, entrepreneurs, and academicians to promote the Society as an innovations leader in the PA/LTC setting. In this session, IPAC leaders will provide an overview of the IPAC charter and initial projects undertaken by the group. The session will also invite several PA/LTC innovators to present their work to the audience who will then select the two winners of the first ever Society Innovations Challenge.

Learning Objectives:
(1) Describe the Innovations Platform Advisory Committee (IPAC) Charter for AMDA Innovations.
(2) Discuss next steps to incorporate Innovations in to AMDA's culture.
(3) Review finalists selected by the IPAC to compete in the Shark Tank competition.

Speakers
avatar for Christopher Laxton, CAE

Christopher Laxton, CAE

Christopher Laxton, CAE, is a career association professional with over 30 years of experience in nonprofit leadership, governance and operations and has been the Executive Director of AMDA since February 2013.
avatar for Arif Nazir, MD, CMD

Arif Nazir, MD, CMD

Arif Nazir, MD, CMD, is a geriatrician and the Chief Medical Officer for Signature HealthCare and in that capacity oversees delivery of innovative clinical programs in more than 130 skilled facilities across ten different states. Among many other previous roles, Dr. Nazir provided... Read More →
avatar for Cari Levy, MD, PhD, CMD

Cari Levy, MD, PhD, CMD

Cari Levy, MD, PhD, CMD, is a geriatrician and Certified Medical Director with board certification in Hospice and Palliative Medicine. In her role as Associate Director of the Denver-Seattle Center for Veteran-Centric and Value-Driven Care, she works with over 30 health services researchers... Read More →


Friday March 23, 2018 1:30pm - 3:00pm MST
San Antonio 5-6
  Models of Care

1:30pm MST

FR18 | Coming Soon to Your Town: Post-Acute Networks and APMs
This session will discuss the importance of Post-Acute Network formation, the processes involved in selection and maintenance and the impact it will have on post-acute care providers. The importance of networks to the value-based payment (VBP) concept will be reviewed, along with suggestions as to how to assist with positioning your facilities for participation. An integral part of these changes will be advanced alternative practice models (Advanced APMs), which are designed to move clinicians away from fee-for-service to value-based payment. Advanced APMs are APMs where providers must bear more than “nominal financial risk” for monetary losses and ensure quality, in addition to other criteria. Currently there are no specific PA/LTC APMs, but there are some that will involve these settings. There is a significant opportunity for the Society to not only participate effectively in pertinent APMs, but more importantly to create new models specific for the populations we serve.

Learning Objectives:
(1) Discuss Why Post-Acute Networks are being formed, and how participating Facilities are chosen.
(2) Compare the merits of MIPS and Advanced APMs.
(3) Review current Advanced APMs that include PA/LTC care sites.
(4) Describe the potential advantages of a PA/LTC specific Advanced APMs.

Speakers
avatar for Charles Crecelius, MD, PhD, CMD

Charles Crecelius, MD, PhD, CMD

Charles Crecelius, MD, CMD, PhD, is currently the medical director at Willowbrook Medical Center. He is the immediate past chair of AMDA’s Public Policy Committee and is a Past President of AMDA among his many other leadership positions within the organization.
avatar for Kerry Weiner, MD, MPH

Kerry Weiner, MD, MPH

Kerry Weiner, MD, MPH, is currently the Chief Medical Officer for IPC-The Hospitalist Company, Inc. (Nasdaq:IPCM), a leading national physician group practice company. In his role, Dr. Weiner is responsible for the ongoing development of leadership skills for IPC's 1,400 hospital... Read More →


Friday March 23, 2018 1:30pm - 3:00pm MST
Texas Ballroom C
  Practice Management

3:30pm MST

FR19 | Sepsis in LTC: Recognition and Appropriate Response
This session will address the presentation of sepsis in older adults, early recognition of sepsis in PA/LTC residents and realistic expectations for managing sepsis based on the staff, training, and resources available in most PA/LTC settings.

Learning Objectives:
(1) Describe the clinical presentation of sepsis in older adult.
(2) Discuss initial assessment and management of an older adult with possible sepsis.
(3) Recognize the risks and benefits of attempting to manage sepsis in the PA/LTC setting.


Friday March 23, 2018 3:30pm - 5:00pm MST
Texas 1-2
  Clinical Medicine

3:30pm MST

FR20 | This Year in Review for LTC
In this session, we present 8-15 articles published in the past year which have the potential to impact the practice of medicine and the processes of care for frail elders in the continuum of care. All articles are chosen through a Modified-Delphi approach and critically appraised by experienced, multidisciplinary practitioners and educators. This presentation has been well-received each year and is often the site of spirited discussion.

Learning Objectives:
(1) Consider changes in your practice based on recent publications.
(2) Identify publications that are controversial and/or may affect the direction of research.
(3) Describe techniques for critiquing publications.

Speakers
avatar for Milta Little, DO, CMD

Milta Little, DO, CMD

Milta Little, DO, CMD, is an Associate Professor of Medicine at St. Louis University in the Division of Geriatric Medicine. She is board certified in General Internal Medicine, with added qualifications in Geriatric Medicine. She serves the division as Program Director of the Geriatric... Read More →
avatar for Julie Gammack, MD, CMD

Julie Gammack, MD, CMD

Julie Gammack, MD, CMD, is a Professor of Medicine at St. Louis University School of Medicine. She is the Associate Dean for Graduate Medical Education, past Program Director for the Geriatric Medicine Fellowship, and a Medical Director at a teaching nursing home. She is a member... Read More →


Friday March 23, 2018 3:30pm - 5:00pm MST
Texas 3-4
  Clinical Medicine

3:30pm MST

FR21 | Advancing Resident-Centered Care in LTC Facilities: The Value of Ethics Committees and Resources
This session, presented by an attorney, bioethicist, and a long time medical director, will detail and reinforce the use of the interprofessional bioethics committee format in skilled nursing facilities, with a specific eye toward promoting resident-centered care and autonomy, and taking into account risk management principles. The session will also review determination of decisional capacity, and includes content on working with incapacitated, unrepresented patients. In addition to didactic content, case presentations and small group discussion will be utilized.

Learning Objectives:
(1) Implement an interprofessional ethics evaluation framework to support resident-centered care decisions in PA/LTC, including the medical director as a vital participant.,
(2) Assess decision-making capacity for nursing home residents with respect to a variety of situations. ,
(3) Apply the principles of bioethics to direct resident-centered care in light of risk management concerns.,
(4) Formulate strategies to improve medical decision-making for incapacitated unbefriended (unrepresented) nursing home residents.


Friday March 23, 2018 3:30pm - 5:00pm MST
Texas 5-6
  Clinical Medicine

3:30pm MST

FR23 | ASCP Session
Details coming soon.

Speakers
avatar for Cari Levy, MD, PhD, CMD

Cari Levy, MD, PhD, CMD

Cari Levy, MD, PhD, CMD, is a geriatrician and Certified Medical Director with board certification in Hospice and Palliative Medicine. In her role as Associate Director of the Denver-Seattle Center for Veteran-Centric and Value-Driven Care, she works with over 30 health services researchers... Read More →
avatar for Chad Worz, PharmD

Chad Worz, PharmD

Chad Worz, PharmD, received his Bachelors of Science and post-B.S. Doctor of Pharmacy from the University of Cincinnati in 1996 and 1998. In July of 2007, Chad established Medication Managers, LLC, whose mission is to educate and serve nursing home residents, nursing home administration... Read More →


Friday March 23, 2018 3:30pm - 5:00pm MST
Austin 4-6
  Clinical Medicine

3:30pm MST

FR24 | Managing Heart Failure Patients in Skilled Nursing Facilities: Addressing the Complex Cardiovascular Disease, and Knowing When and how to Incorporate Palliative Care (AGS/AMDA Joint Session)
This session will provide attendees with an in-depth understanding of the issues affecting the care of patients with heart failure in skilled nursing facilities (SNFs). It is intended to provide attendees with expert insight into improving quality of care provided to this complex subset of patients. The speakers will review the clinical factors contributing to poor outcomes among these patients, provide insight into optimizing the medical management, and developing algorithms of care for these patients within their goals of care and expected discharge status, and discuss the indications, importance, and emerging use of palliative care and hospice consultation to patients with advanced/end stage heart failure.

Learning Objectives:
(1) Describe the SNF patient with CVD as a distinct high-risk patient with significantly increased morbidity, mortality, and risk for hospital readmission, and the importance of providing high quality care to these patients in the current regulatory environment.
(2) Discuss principles of cardiovascular disease management within the context of multimorbidity and goal directed patient care in the skilled nursing facility setting.
(3) Explain the need and methods for developing algorithms of care for complex heart failure patients in the SNF setting to improve patient outcomes, quality, and value of care.
(4) Discuss the importance of utilizing palliative care in patients with advanced heart failure in the SNF setting.
(5) Review the principles guiding patient selection for palliative care consultation, and medical management for refractory symptoms related to cardiovascular disease.

Speakers
avatar for Nicole Orr, MD

Nicole Orr, MD

Nicole Orr, MD, FACC, is an Assistant Professor of Medicine in the Division of Cardiology at Tufts University School of Medicine, and the founder and president of Post Acute Cardiology Care, LLC. She serves both as a staff cardiologist and consultant to several skilled nursing facilities... Read More →
avatar for Rebecca Boxer, MD

Rebecca Boxer, MD

Rebecca Boxer, MD, is an Associate Professor of Medicine in the Divisions of Geriatric Medicine and Cardiology at the University of Colorado School of Medicine. She is presently the principal investigator of a randomized controlled trial of heart failure disease management in skilled... Read More →


Friday March 23, 2018 3:30pm - 5:00pm MST
Ft. Worth 5-7
  Clinical Medicine

3:30pm MST

FR22 | Medical Director Collaboration to Yield a More Meaningful Meeting (and Fun) for all Participants
While federal and state regulations require quality assurance performance improvement (QAPI) meetings, which are often led by the administrator or medical director, the full potential of the meetings is often limited by individuals’ contributions to the meetings, interprofessional relationships, and follow-up of identified issues. Interdisciplinary team (IDT) members may struggle with understanding the value of their roles during QAPI meetings and how to better participate in a productive manner. The collaborative relationship among the medical director, administrator, and director of nursing provides the foundation for leading productive and efficient QAPI meetings. In this session, sponsored by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM), experienced IDT members build upon the previous years’ session to assist the triad of leadership in nursing facilities in their goals of improving QAPI meetings and subsequent care outcomes, resident experience, and the quadruple aim. Based on trends and past performance, create a vision and direction for your facility which guides QAPI meeting.

Learning Objectives:
(1) Build a foundation for a productive QAPI meeting and subsequent performance by developing and/or improving skills in collaboration among the Medical Director-Administrator-Director of Nursing leadership triad.
(2) Based on trends and past performance, create a vision and direction for your facility which guides QAPI meetings.
(3) Develop a plan to maximize the value of technology, such as an EMR, in a facility’s QAPI meeting.
Leverage value of each individual members’ participation in the QAPI meeting.

Speakers
avatar for Thomas Edmondson, MD, CMD

Thomas Edmondson, MD, CMD

Tom Edmondson, MD, CMD, AGSF, FACP is a geriatrician in the Baltimore region and currently serves as Chair of the American Board of Post-Acute and Long-Term Care Medicine. He is president of MMDA--The Mid-Atlantic Society for Post-Acute and Long Term Care Medicine, and he serves on... Read More →


Friday March 23, 2018 3:30pm - 5:00pm MST
Dallas 5-6
  Medical Direction

3:30pm MST

FR26 | Stopping Eating and Drinking by Advance Directives: Choose Your Injustice
This session will discuss the ethical dilemmas involved in an advance directive that asks the provider to withhold food and fluid in patients with dementia. The presentation will focus on the dilemma of autonomy and the injustice inherent in a decision to implement or to refuse to implement the advance directive. A panel discussion by members of the Society Ethics Committee will follow.

Learning Objectives:
(1) Discuss the concepts of Voluntarily Stopping Eating and Drinking (VSED) and Stopping Eating and Drinking by Advance Directives (SED by AD).
(2) Describe the various ethical issues involved in implementing SED on a patient with advanced dementia.
(3) Explain the difference between critical and experiential interests and how they contribute towards ethical decision making.
(4) Appreciate the practical difficulties in implementing SED in the nursing home or assisted living setting.


Friday March 23, 2018 3:30pm - 5:00pm MST
San Antonio 5-6
  Medical Direction

3:30pm MST

FR25 | Reports from the Front: Updates On the Approach to UTI From Three Stewardship Projects
This session will provide participants with emerging information regarding urinary tract infection (UTI) management from national and international antimicrobial stewardship projects. The session will discuss implementation of new guidelines for the diagnosis of UTI, the development of new guidelines for the diagnosis and management of uncomplicated cystitis, and the presenter's experience in implementing a post-prescribing antibiotic time out as recommended by the Centers for Disease Control and Prevention (CDC).

Learning Objectives:
(1) Discuss facilitators and barriers with regard to implementation of a restrictive antibiotic prescription policy for UTI.
(2) Describe new guidelines for the diagnosis and treatment of uncomplicated cystitis in nursing home residents.
(3) Discuss factors to consider in the implementation of a post-prescribing antibiotic time out.

Speakers
avatar for David Nace, MD, MPH, CMD

David Nace, MD, MPH, CMD

David Nace, MD, MPH, CMD, is an Associate Professor of Medicine in the Division of Geriatric Medicine at the University of Pittsburgh. He serves as the Director of LTC and Influenza Programs for the division and as Chief of Medical Affairs for UPMC Senior Communities. Dr. Nace chairs... Read More →
avatar for Christopher Crnich, MD, PhD

Christopher Crnich, MD, PhD

Christopher Crnich, MD, PhD, is Chief of Medicine at the Madison Wisconsin VA and an Associate Professor of Medicine in Infectious Disease at the University of Wisconsin School of Medicine and Public Health. Dr. Crnich is the principal or co-investigator on a number of federally funded... Read More →


Friday March 23, 2018 3:30pm - 5:00pm MST
San Antonio 4
  Research
 
Saturday, March 24
 

6:00am MST

SA1 | Meet the Expert Breakfast Session -- When the Benefits Outweigh the Risks: Managing Chronic Mental Illness in PA/LTC
This session will review a paradigm for treating two separate groups of people living in the PA/LTC setting. The session will focus on how to maintain stability for those who live with chronic mental illness who now live long enough to age into multiple comorbidities. There may be a history of homelessness, substance abuse, and intermittent institutionalization. Next, Maureen Nash, MD, will review an evidence-based approach to managing dementia with behavior disturbance with an emphasis on treating aggression and sexual disinhibition.

Dr. Nash is the medical director of the Providence ElderPlace Oregon Program of All-inclusive Care for the Elderly (PACE). As the medical director, she has increased the integration of behavioral health in the primary care clinics of the ElderPlace Oregon health care system, improving the quality of care while decreasing inappropriate utilization of health care services for dual eligible frail older adults. Prior to that she was the medical director of two different geriatric psychiatry inpatient units, one in upstate New York and one in Oregon. She is Board Certified in Internal Medicine and Psychiatry and is active in the American Association for Geriatric Psychiatry and the American Psychiatric Association Council on Geriatric Psychiatry. Dr. Nash is an affiliate assistant professor in psychiatry at Oregon Health and Sciences University School of Medicine.

Learning Objectives:
(1) Describe three reasons why those with chronic mental illness are likely to end up living in long-term care settings.
(2) Discuss the risks and benefits of behavioral and nonpharmacological interventions as part of the overall approach to working with people who have chronic mental illness.
(3) Explain an evidence based approach to considering risks and benefits of pharmacological interventions.
(4) Use an evidence based algorithm for treating those with behavior disturbance in the context of moderate to severe dementia.
(5) Discuss the evidence for treating sexual disinhibition and differentiate that from intimacy seeking behaviors.

Speakers

Saturday March 24, 2018 6:00am - 7:45am MST
Texas D
  Clinical Medicine

8:00am MST

SA2 | General Session II
Opening Remarks
Cari Levy, MD, PhD, CMD, Society President-Elect

Award Presentation
Howard Guterman Best Poster Award
Alan Abrams, MD, CMD

The Society’s Top Policy Issues 2018
Updates on the top Society activity on policy issues including the following: legislative advocacy, communications with government agencies, updates on the health care reform implementation efforts, and on proposed changes to PA/LTC facilities requirements for participation.
Karl Steinberg, MD, CMD, Chair, Public Policy Committee; David Nace, MD, MPH, CMD, Vice Chair, Public Policy Committee; Alex Bardakh, MPP, Director, Public Policy and Advocacy

Speakers
avatar for David Nace, MD, MPH, CMD

David Nace, MD, MPH, CMD

David Nace, MD, MPH, CMD, is an Associate Professor of Medicine in the Division of Geriatric Medicine at the University of Pittsburgh. He serves as the Director of LTC and Influenza Programs for the division and as Chief of Medical Affairs for UPMC Senior Communities. Dr. Nace chairs... Read More →
avatar for Karl Steinberg, MD, CMD

Karl Steinberg, MD, CMD

Karl Steinberg, MD, CMD, has been a nursing home and hospice medical director, attending physician and educator in San Diego for over 20 years and is editor-in-chief of Caring for the Ages in addition to serving on AMDA's Board of Directors and multiple committees. He is a frequent... Read More →
avatar for Cari Levy, MD, PhD, CMD

Cari Levy, MD, PhD, CMD

Cari Levy, MD, PhD, CMD, is a geriatrician and Certified Medical Director with board certification in Hospice and Palliative Medicine. In her role as Associate Director of the Denver-Seattle Center for Veteran-Centric and Value-Driven Care, she works with over 30 health services researchers... Read More →
avatar for Alex Bardakh, MPP

Alex Bardakh, MPP

Alex Bardakh, MPP, PLC, is the Director of Public Policy & Advocacy for AMDA – The Society for Post-Acute and Long-Term Care Medicine. Alex is a tireless worker for the Society’s extensive Public Policy agenda through Advocacy in Congress and numerous Federal Agencies. A graduate... Read More →


Saturday March 24, 2018 8:00am - 10:30am MST
Texas Ballroom A-B
  General Session

11:00am MST

SA10 | Disaster Preparedness 101
Serious weather-related or other types of disasters can severely impact our ability to safely care for our residents. The evaluation and decision process to shelter in place or to evacuate residents is critical to best care for our communities of residents. Last fall’s Hurricane Harvey posed a widespread risk to several nursing facilities in the Houston, Texas area. This session will cover case presentations and group discussion of the following aspects of responding to a disaster: ongoing baseline disaster preparedness for nursing facilities, the decision-making process when a substantial threat is identified, mobilizing resources to assist in facility evacuation, tracking the evacuation of individual residents, assuring that medications and other services remain available for residents throughout the process.

Learning Objectives:
(1) Discuss the physical and regulatory risks of hurricanes and other natural disasters.
(2) Demonstrate knowledge of the components of a comprehensive disaster response plan.
(3) Explain how effective coordination of the interdisciplinary team is crucial to a successful response.
(4) Describe how effective communication with the electronic medical record system is essential for coordination of pharmacy providers, administrators, directors of nursing, and medical directors in the facilities that are evacuating and receiving residents during a natural disaster.

Speakers
avatar for Mary Evans, MD, CMD

Mary Evans, MD, CMD

Mary Evans, MD, CMD, started a LTC practice eleven years ago, has worked as an attending physician and medical director for several years before being recruited by Golden Living as a Regional Medical Director. Her current position is as Compliance Executive Physician at Golden Living... Read More →


Saturday March 24, 2018 11:00am - 12:00pm MST
San Antonio 2-3
  Medical Direction

11:00am MST

SA11 | The “How To” Implementation of Pain Management, Pressure Ulcers and Other Wounds, and Heart Failure Clinical Practice Guidelines in PA/LTC
Clinical challenges such as pain, wounds, and heart failure are prevalent in the PA/LTC setting and managing these conditions effectively requires that the interprofessional team develop a plan of care that supports patient-centered goals that are both realistic and achievable while striving to provide optimal care to each patient. Pain in the PA/LTC setting affects rehabilitation and mood and pain management should be considered a patient’s right in the PA/LTC setting. However, with the opioid epidemic and new rules it is essential to follow the regulations, but also address pain effectively. Pressure ulcers and other wounds remain a major cause of morbidity and mortality, affecting an estimated 2.5 million patients per year and costing up to $11.6 billion dollars per year in the United States. Readmission after a hospitalization for heart failure is still common among PA/LTC patients, with almost half of the patients readmitted within 6 months. Furthermore, for each of these conditions, older adults almost always have multimorbidity that influences the treatment of the primary condition. The workshop will utilize the clinical practice guidelines and their accompanying pocket guides as a framework for discussion of common patient scenarios involving acute and chronic pain, wounds, and heart failure. During the workshop, there will be specific attention to strategies for utilization and implementation of the evidence-based guidelines in the real world.

Learning Objectives:
(1) Discuss best practice methods to promote the interprofessional implementation of clinical practice guidelines in their facilities.
(2) Incorporate the pain management, pressure ulcers and other wounds, and heart failure clinical practice guidelines in their facilities.

Speakers
avatar for Gwendolen Buhr, MD, MEd, CMD

Gwendolen Buhr, MD, MEd, CMD

Gwendolen Buhr, MD, MEd, CMD, is an Associate Professor in the Department of Medicine, Division of Geriatrics at Duke University Medical Center. She works as an educator and clinician teaching and practicing in the long‐term care setting. She earned her MD from the University of... Read More →
avatar for Robert Hogikyan, MD, MPH, CMD

Robert Hogikyan, MD, MPH, CMD

Robert Hogikyan, MD, MPH, CMD, is Clinical Associate Professor of Internal Medicine at the University of Michigan and the current Section Chief, Geriatric Medicine within Medicine Service at the VA Ann Arbor Healthcare System (VAAAHS). He is Program Director of the VA Fellowship in... Read More →
avatar for Deborah Way, MD, CMD

Deborah Way, MD, CMD

Deborah Way, MD, CMD, FAAHPM, is an internist with subspecialty board certification in geriatrics and hospice and palliative medicine. She has provided primary geriatric care and hospice and palliative care across the care spectrum. Dr. Way  provides palliative care and end of life... Read More →


Saturday March 24, 2018 11:00am - 12:30pm MST
Grapevine B
  Medical Direction

11:00am MST

SA4 | Billing and Coding in PA/LTC: How to Do it Right!
This session will provide details about billing for services that have recently been approved by the Centers for Medicare & Medicaid Services. Participants will learn the peculiarities of the billing changes for these codes, The session will also review and explore the finer points of some classical billing and coding enigmas that continue to be challenging for many PA/LTC practitioners.

Learning Objectives:
(1) Discuss details of billing complexities for recently approved billing codes used in the geriatric care continuum.
(2) Review details of some recurrently perplexing PA/LTC coding and billing issues.

Saturday March 24, 2018 11:00am - 12:30pm MST
Texas 3-4
  Medical Direction

11:00am MST

SA5 | Antibiotic Stewardship, Infection Prevention and Control: Three Perspectives on the Reform of Requirements from the Centers for Medicare and Medicaid Services
The Center for Medicare & Medicaid Services (CMS) issued a comprehensive reform of the requirement for LTC facilities to participate in Medicare and Medicaid programs. This session will review the changes relevant to infection prevention and control and antibiotic stewardship, from the perspectives of an infection preventionist, a consultant pharmacist, and an infectious disease physician.

Learning Objectives:
(1) Discuss the infection preventionist’s role and responsibilities indicated in the 2016 Reform of Requirements of Participation.
(2) Review the pharmacy services and the consultant pharmacists’ expanded role in infection prevention and control and antibiotic stewardship programs.
(3) Describe basic components of an antibiotic stewardship program, including an antibiotic stewardship policy and antibiotic use protocols appropriate for PA/LTC settings.

Speakers
avatar for Robin Jump, MD, PhD

Robin Jump, MD, PhD

Robin Jump, MD, PhD, is an Infectious Disease physician at the Louis Stokes Cleveland Veterans Affairs Medical Center and Assistant Professor of Medicine at Case Western Reserve University.  She has research support from the VA and AHRQ.  Her long-term academic interests are to... Read More →


Saturday March 24, 2018 11:00am - 12:30pm MST
Texas 5-6
  Medical Direction

11:00am MST

SA6 | Beyond 5-Star Quality Rating System, A Guide to Survive The New Changes
Centers for Medicare & Medicaid Services (CMS) has made several changes to the Quality Measure Domain (QM) of the 5- Star Quality Rating System, as well as the staffing data submission. The new quality measures are related to successful discharges to the community, emergency department visits, re-hospitalization, and improvement and maintenance of a resident’s function. This session will primarily focus on the impact of the new changes in the overall star rating and its effect on the facilities, with a particular emphasis on practical approaches, case studies, and QAPI interventions to improve on the new quality measures.

Learning Objectives:
(1) Describe the 5-star quality rating system and its three domains.
(2) Identify the new developments in staffing data submission- Payroll Based Journal (PBJ).
(3) Explain the five new quality measures (QM), QAPI interventions to successfully improve quality and the new QM Metrix.
(4)

Speakers
avatar for Sabine von Preyss-Friedman, MD, CMD

Sabine von Preyss-Friedman, MD, CMD

Sabine von Preyss-Friedman, MD, CMD, is Associate Clinical Professor of Medicine at the University of Washington. Currently, she serves as Medical Director for several Skilled Nursing Facilities in the Seattle, WA area. Dr. von Preyss-Friedman also holds a position as Chief Medical... Read More →
avatar for Ashkan Javaheri, MD, CMD

Ashkan Javaheri, MD, CMD

Ashkan Javaheri, MD, CMD, completed his family medicine residency at Eastern Virginia Medical School followed by a Geriatric Fellowship at Stanford University School of Medicine. He is Assistant Professor at UC Davis School of Medicine and the Head of Geriatric Division at Mercy Medical... Read More →
avatar for Irene Hamrick, MD

Irene Hamrick, MD

Irene Hamrick, MD, is an Associate Professor and the Geriatric Services Director of the department of Family Medicine at the University of Wisconsin in Madison. She was previously the Chief of Geriatrics at East Carolina University, where she was for 20 years including her medical... Read More →


Saturday March 24, 2018 11:00am - 12:30pm MST
Dallas 5-6
  Medical Direction

11:00am MST

SA8 | Lessons from Litigation: A Tool for Performance Improvement in PA/LTC Facilities
This session features two experienced medical directors of PA/LTC facilities with many years of experience in providing consulting and expert witness services to providers and attorneys involved in various types of litigation in the PA/LTC arena. They have distilled unique teaching points from many cases and will discuss how providers and facilities can learn from these and implement various interventions, policies, and process improvements pertinent to their own facilities to improve exposure to common areas of liability and potentially avoid litigation.

Learning Objectives:
(1) Describe the main areas of litigation commonly encountered in PA/LTC facilities.
(2) Discuss ways the medical director, attending physician, administrator and DON can glean lessons from PA/LTC litigation to use for performance improvement activities in their facilities that can serve to lessen the chance of being involved in litigation.
(3) Recognize the importance of recognition of 'near miss' events and subsequent implementation of follow-up action to prevent liability with adverse outcomes.
(4) Describe the importance of updated care plans that reflect appropriate goals of care for nursing facility residents in reducing the chance of litigation involving nursing facility residents.


Saturday March 24, 2018 11:00am - 12:30pm MST
Austin 4-6
  Medical Direction

11:00am MST

SA3 | To D/C or Not to D/C: Implementing Deprescribing Into Your Clinical Practice
By reviewing the quality improvement (QI) process, this session will offer the PA/LTC health care provider evidence-based and practical suggestions to implementing deprescribing, or more specifically a deprescribing initiative, into clinical practice. It will also review communication techniques for deprescribing utilizing case-based vignettes.

Learning Objectives:
(1) Review the role of deprescribing in management of polypharmacy or potentially inappropriate medications in PA/LTC residents.
(2) Explore and debate the elements of a successful PA/LTC deprescribing initiative within the QAPI format.
(3) Practice communication strategies for deprescribing with residents, family and caregivers, and other practitioners.

Speakers
avatar for Steven Handler, MD, PhD, CMD

Steven Handler, MD, PhD, CMD

Steven Handler, MD, PhD, CMD, is an Associate Professor with a primary appointment in the Division of Geriatric Medicine, where he serves as the Director of Geriatric Telemedicine Programs. He has secondary appointments in the Department of Biomedical Informatics, and Clinical and... Read More →


Saturday March 24, 2018 11:00am - 12:30pm MST
Texas 1-2
  Models of Care

11:00am MST

SA9 | What the Multidisciplinary Team in Nursing Homes Need to Know About Changing Models of Healthcare in the Community
This panel will discuss how changes in our care delivery systems across the country are integrating medical and social supports services for better outcomes for patients and families living in the community and skilled nursing facilities A range of models will be discussed to better deliver care such as case managers for high risk patients and how different states are moving to managed LTC services and supports (MLTSS) which include services for those living in nursing homes. Topics include: 1) how different states are changing how LTC services are delivered and financed, 2) how high risk patients are being managed more in the community with waiver programs, 3) how one state is using a social justice model to help older adults live at home, and 4) how a state is making accountable care organizations and incorporating LTC into the medical system.

Learning Objectives:
(1) Describe how different states are changing how long term care services are delivered and financed.
(2) Discuss how high risk patients are being managed more in the community with waiver programs.
(3) Explain how one state is using a social justice model to help older adults live at home.
(4) Review how one state is making Accountable Care Organizations and incorporating LTC.


Saturday March 24, 2018 11:00am - 12:30pm MST
Ft. Worth 5-7
  Models of Care

11:00am MST

SA7 | Quality Improvement Awards and Expert Panel Discussion
This session will focus on the collaborative and interdisciplinary nature of improving the quality of care and life for PA/LTC residents. It will feature presentations by the Foundation's 2017 Quality Improvement Award winner on the "Quality of Dementia End-of-Life (EOL) Care in Nursing Homes using Quality Data Collection Tool for Palliative Care (QDACT-PC) Registry," as well as presentation from the winners of the 2018 QI & Health Outcome (QIHO) Award. These awards are centered on programs that facilities have successfully implemented to improve the quality of life for their residents. These presentations will form the basis for discussion by Robert Kaplan, MD, CMD, Thomas Caprio, MD, CMD, and Dulce Maria Cruz Oliver, MD. The discussion will serve to highlight the relationship between individual QI initiatives and larger research projects and trends that strengthen the quality of life across the PA/LTC continuum.

Learning Objectives:
(1) Appreciate the diversity and impact of quality improvement and quality of life projects in the PA/LTC setting.
(2) Describe the difference in project design and implementation of quality of care and quality of life projects.
(3) Discuss the challenges in impacting the quality of care and life in the PA/LTC setting.

Speakers
avatar for Thomas Caprio, MD, CMD

Thomas Caprio, MD, CMD

Thomas Caprio, MD, CMD, is an Associate Professor of Medicine, Dentistry, Clinical Nursing, and Public Health Sciences at the University of Rochester Medical Center in Rochester, New York. He serves as director of the geriatric medicine fellowship training program, director of the... Read More →


Saturday March 24, 2018 11:00am - 12:30pm MST
Dallas 7
  Research

1:00pm MST

ITT | In-the-Trenches: Peer Group Roundtable Discussion
A variety of hot topics in PA/LTC practice settings will be selected for small group discussions and will be facilitated by conference speakers. A complete list of topics will be provided online and onsite at the meeting. There is no advance sign-up to participate in the roundtable discussions. It is first come, first served. Lunch will be available for purchase. This session does not offer CME.

Saturday March 24, 2018 1:00pm - 2:00pm MST
Texas D

2:30pm MST

SA12 | Why is Mom Dying? A Communication Method for Helping Families and Nursing Home Staff Cope with Natural Dying Process of Dementia Diagnoses
In this session, participants will learn a practical approach to addressing the concerns that arise for families and staff members when a person with a dementia diagnoses stops eating or develops dysphagia. The presentation emphasizes an approach that alleviates guilt and grief of the caretakers, makes sense of the natural process occurring and allows informed decision making on options of alternate nutrition.

Learning Objectives:
(1) Review the science of aging/dementia and anorexia.
(2) List the stepwise progression of anorexia that occurs in dementia diagnoses in a manner that makes sense.
(3) Use communication techniques that alleviates guilt of caregivers.
(4) Allow informed decision making in regards to potential alternate nutritional methods.


Saturday March 24, 2018 2:30pm - 3:30pm MST
Texas 1-2
  Clinical Medicine

2:30pm MST

SA13 | Innovative Approaches to Implement Evidence Based Deprescribing Practices in PA/LTC Setting
This session will address problems associated with polypharmacy in PA/LTC setting and provide strategies to address these problems. The speakers will offer practical tools that can be helpful in deprescribing in the PA/LTC setting.

Learning Objectives:
(1) Discuss current evidence from deprescribing interventions in PA/LTC.
(2) Explain how to overcome barriers to deprescribing in PA/LTC setting.
(3) Explore deprescribing strategies for antipsychotics and opiates in PA/LTC setting.
(4) Describe how to engage interprofessional team members in addressing deprescription in PA/LTC setting.

Speakers
avatar for Dheeraj Mahajan, MD, CMD

Dheeraj Mahajan, MD, CMD

Dheeraj Mahajan, MD, CMD, CIC, is currently the President and CEO of CIMPAR, S.C. (Chicago Internal Medicine Practice and Research). He also holds an academic appointment as the Clinical Assistant Professor of Medicine, University of Chicago, Illinois. In addition to being President... Read More →
avatar for John Derr, RPh

John Derr, RPh

John Derr, RPh, is a thought leader and advocate for PA/LTC having served on many federal and state committees, task forces, and CMS grants. He has also been a consultant to many providers and vendors of PA/LTC. He served as EVP of AHCA/NCAL and SVP/CIO for Golden Living. He was a... Read More →


Saturday March 24, 2018 2:30pm - 3:30pm MST
Texas 3-4
  Clinical Medicine

2:30pm MST

SA16 | The Emergency Department Joins the Interdisciplinary Team: Strategies to Improve Acute Care Transitions and Reduce ED Capture
This session will explain how PA/LTC nurses, providers, and administrators can partner with receiving emergency departments (EDs) to improve the transitions between their sites, enhance resident safety in the ED, and reduce potentially avoidable hospitalizations.

Learning Objectives:
(1) Design a program to enhance collaboration with the emergency department.
(2) Evaluate their site's PA/LTC to ED transition process and identify areas of improvement.
(3) Explain the unique challenges of treating PA/LTC residents in the emergency department.
(4) Discuss the Geriatric ED Guidelines as they relate to the PA/LTC to ED transition.


Saturday March 24, 2018 2:30pm - 3:30pm MST
Austin 4-6
  Clinical Medicine

2:30pm MST

SA17 | Providing PA/LTC to Adults With Intellectual and Developmental Disabilities
This session will provide a clinical introduction to caring for adults with intellectual and developmental disabilities in PA/LTC settings, based on literature review and the presenter's 25 years of experience as a clinician, medical educator, and researcher in developmental disabilities medicine. The content material presented will be applied to four case scenarios which exemplify the breadth and complexity of health care in this population. Participants will develop and share proposals for a quality improvement initiative aiming to improve care of this population, tailored to the facilities where they practice.

Learning Objectives:
(1) Describe how the etiologic diagnosis for the developmental disability guides clinical care of this population.
(2) Apply a literature-based, culturally- sensitive model of health care to persons with IDD in PA/LTC.
(3) Outline key elements of a quality improvement initiative addressing the health care for persons with IDD in facilities where they practice.

Saturday March 24, 2018 2:30pm - 3:30pm MST
Ft. Worth 5-7
  Clinical Medicine

2:30pm MST

SA18 | Optimizing Function and Physical Activity Among Residents in AL Using a Dissemination and Implementation Approach
This session will describe the current functional and physical activity of assisted living (AL) residents and the importance of addressing function and activity among these individuals to prevent further decline. A theoretically based, practical approach using a four-step process will be shared as a way to implement a function focused care approach into any AL setting. The steps include: (1) Assessment of the environment and policies; (2) education of staff; (3) development of appropriate service plans based on resident capability; and (4) mentoring and motivating. Exemplars will be shared as well from real world implementation activities. Participants will receive the necessary tools and techniques to implement a function focused care approach into their settings as well as the ways in which to over the barriers commonly encountered.

Learning Objectives:
(1) Describe the current functional status of older adults in AL settings.
(2) Define Function Focused Care and provide examples of this type of care.
(3) State the four steps to implementing Function Focused Care in AL environments.
(4) Describe three challenges and the ways to overcome those challenges and successfully implement Function Focused Care in AL settings.


Saturday March 24, 2018 2:30pm - 3:30pm MST
San Antonio 2-3
  Clinical Medicine

2:30pm MST

SA19 | Pioneer Network: Helping You Find the Processes to Support Your Passion
For many providers, passion drives the desire to implement person-centered practices in their community. For others, the driver may not be passion, but the need to comply with the new regulatory requirements imposed by the Centers for Medicare & Medicaid Services (CMS). We know that passion alone will not assure sustainable practices and certainly we have all seen attempts at regulatory compliance which are short lived, more of a band aid than a cure. Pioneer Network has long supported the need to create processes and systems to support passion and provide the foundation needed to sustain person-centered practices. In this session, we will explore some foundational practices that can support your passion and drive the implementation and sustainability of person-centered practices. We will identify resources to help build and develop the processes and systems, discuss how to use quality assurance performance improvement (QAPI) to help in the development and sustainability of the person-centered practices, and discuss the role of the medical director in assuring that person-centered practices are the standard in the community.

Learning Objectives:
(1) Identify practices that are based on a medical model and describe ways to replace them with person-centered practices as required by CMS and consumers.
(2) Explain how to develop processes and systems that will support the sustainability of person-centered practices.
(3) Implement strategies within QAPI to implement PCC practices in a systematic way to ensure sustainability.
(4) Find resources to help in the development of processes and systems supporting person-centered practices and recognize how medical practitioners can serve as leaders in this change effort.


Saturday March 24, 2018 2:30pm - 3:30pm MST
Grapevine B
  Models of Care

2:30pm MST

SA14 | Maximizing JAMDA’s Relevance for the PA/LTC Community
JAMDA is the official journal of AMDA – the Society for Post-Acute and Long-Term Care Medicine. In this session, the journal’s new Co-Editors-in-Chief – Philip Sloane, MD, MPH, and Sheryl Zimmerman, PhD, will present their vision, discuss the manuscript submission and review process, and invite comments and suggestions from attendees.

Learning Objectives:
(1) Explain the purposes and mission of JAMDA – The Journal of PA/LTC Medicine.
(2) Discuss the vision and proposed expanded emphases under the new editors-in-chief.
(3) Describe principles of successful authorship and manuscript review.


Saturday March 24, 2018 2:30pm - 3:30pm MST
Texas 5-6
  Professional Development

2:30pm MST

SA15 | Improving Dementia Care Through MUSIC and MEMORYsm Program: The California Experience
This session will present the methodologies and findings of a 3-year study that examined the effects of MUSIC and MEMORY on reducing antipsychotics and improving behaviors of residents with dementia in over 250 California nursing homes. Additionally, we will discuss in detail the experiences of nursing home staff in the implementation of this program as a quality assurance performance improvement (QAPI) initiative. Time will be spent with the audience members to discuss ways to improve QAPI implementation based on the findings from this study.

Learning Objectives:
(1) Discuss the impact of MUSIC and MEMORY as a non-pharmacological intervention for residents with dementia.
(2) Describe the collaboration between California Association of Health Facilities and UC Davis in conducting this study.
(3) Examine facilitators and challenges to the implementation of a QAPI initiative.
(4) Recognize how to adapt and apply the methodologies used in this program to other situations and topics.

Speakers
avatar for Debra Bakerjian, PhD, APRN

Debra Bakerjian, PhD, APRN

Debra Bakerjian PhD, FNP, FAAN, FAANP, is associate clinical professor, at the Betty Irene Moore School of Nursing at UC Davis. She has over 25 years of nursing homes practice experience and has served as a consultant to many nursing homes in the area of quality of care and patient... Read More →


Saturday March 24, 2018 2:30pm - 3:30pm MST
Dallas 5-6
  Research

4:00pm MST

SA21 | Dementia Care Conversations
People with dementia lose expressive and receptive language ability and become verbally disabled over time. Clinicians and caregivers rely heavily on language and open-ended questions to connect with patients, assess their needs, and intervene. Without intact language skills, people with dementia have difficulty connecting with others and making their needs known. This session will introduce curricula developed to teach learners from multiple disciplines how to connect, develop a relationship, and communicate with people who have dementia using both verbal and nonverbal skills. These skills are useful in the office, hospital, and PA/LTC setting. And they could potentially help clinicians (from physicians and therapists to CNAs) coach and counsel families about 1) what to expect, 2) how to avoid, and 3) how to respond to challenging situations in dementia care. The speakers will present a brief overview of our curricula and role play learner-coach interactions and skill assessment in this interactive session.

Learning Objectives:
(1) Describe how to connect and develop a relationship with a cognitive-impaired older adult.
(2) Evaluate an individual’s ability to connect and develop a relationship with a cognitively-impaired older adult.
(3) Identify a need or opportunity to develop a dementia care conversations curriculum in their home institutions.


Saturday March 24, 2018 4:00pm - 5:30pm MST
Texas 3-4
  Clinical Medicine

4:00pm MST

SA22 | Urinary and Fecal Incontinence: What to do About it in PA/LTC
This session will discuss the epidemiology, classification, risk factors, and pathophysiology of urinary incontinence (UI) and fecal incontinence (FI) in persons living in the PA/LTC environment. The talk will cover evidence-based recommendations for assessment, treatment, and management of these conditions within the framework of patient-centered goals of care in PA/LTC. Pharmacologic and non-pharmacologic treatment strategies will be reviewed. Psychosocial implications of UI and FI and the importance of patient-provider communication will be highlighted. Interactive case-based scenarios will be utilized. Innovative and emerging treatment techniques such as tibial neuromodulation and a patient-learning community research project will also be presented. < br />
Learning Objectives:
(1) Describe the epidemiology, risk factors, classification, and pathophysiology of urinary and fecal incontinence in the PA/LTC environment.
(2) Discuss evidence-based recommendations for the assessment of urinary and fecal incontinence in the context of patient-centered care in PA/LTC.
(3) List pharmacologic and non-pharmacologic treatment strategies for urinary and fecal incontinence in older adults in the PA/LTC continuum.
(4) Describe patient-oriented goals of care for the interprofessional management and improvement of quality of life for persons with urinary and fecal incontinence in PA/LTC.

Speakers
avatar for Elizabeth Hames, DO, CMD

Elizabeth Hames, DO, CMD

Elizabeth Hames, DO, CMD, is an assistant professor in the Department of Geriatrics at Nova Southeastern University College of Osteopathic Medicine. Dr. Hames is the Associate Program Director for the Geriatric Medicine Fellowship at Broward Health Medical Center. Dr. Hames serves... Read More →
avatar for Kenya Rivas, MD, CMD

Kenya Rivas, MD, CMD

Kenya Rivas, MD, CMD, is an Assistant Professor and Vice Chair of the Department of Geriatrics at Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Florida. She completed her Family Medicine Residency and the Geriatric Fellowship at Florida Hospital... Read More →


Saturday March 24, 2018 4:00pm - 5:30pm MST
Texas 5-6
  Clinical Medicine

4:00pm MST

SA23 | Addressing the Needs and Challenges of Younger Adults in LTC
This session will examine differing needs and risks associated with younger residents in LTC. Speakers will discuss reasons for the growth of this population, and associated challenges as LTC facilities and staff adapt to individuals who may be very long-term residents whom are tech savvy, may retain considerable physical or cognitive capacity, and also may retain interests or personality traits that can be very difficult to manage in a traditional SNF setting.

Learning Objectives:
(1) Describe common medical conditions affecting younger residents and psychosocial correlates of these conditions.
(2) Identify risks that may be associated with younger residents and a strategy to mitigate them.
(3) Develop a care plan to address psychosocial issues of younger residents including activity and risk management components.

Speakers
avatar for Rebecca Ferrini, MD, MPH, CMD

Rebecca Ferrini, MD, MPH, CMD

Rebecca Ferrini, MD, MPH, CMD is the full-time medical director of Edgemoor Hospital DP SNF in Santee, California, a government run 192-bed facility which cares for a younger long-term care population with extensive physical, psychosocial and psychiatric challenges. She was honored... Read More →


Saturday March 24, 2018 4:00pm - 5:30pm MST
Dallas 5-6
  Models of Care

4:00pm MST

SA24 | Creating Memorable Experiences for Residents, Families, and Staff: What Nursing Facilities can Learn From Disney
Whether or not you’re a fan of Disney theme parks, LTC can learn valuable lessons from the success of the Magic Kingdom. Like the theatre or a musical performance, Disney is in the business of creating an experience, rather than merely providing a service. Ironically, health care is not so different (we just don’t realize it yet!). In an effort to integrate a more proactive, positive, and creative focus, this session will offer a paradigm shift in language, culture, and experience for all LTC stakeholders, based on the book "If Disney Ran Your Hospital - 9 ½ Things You Would Do Differently" (Fred Lee, 2004). By focusing team efforts on initiative, empathy, courtesy, and communication, all embraced so effectively by the Disney team, patients and families will focus on their experiences rather than the services provided in participant facilities. Hop in your roller coaster and join us for a unique, fun, and dynamic session...Disney characters welcome!

Learning Objectives:
(1) Discuss the Disney SHARE acronym and explain its utility in long term care.
(2) Identify at least two current practices in their LTC facility that could be improved by integrating the Disney paradigm.
(3) Describe the difference between providing a service and creating an experience and ways to create experiences in PA/LTC care.
(4) Identify two exercises that attendees can facilitate with staff in their LTC facility.

Speakers
avatar for Paige Hector, LMSW

Paige Hector, LMSW

Paige Hector, LMSW, is a clinical educator with over 25 years’ health care experience. Ms. Hector gives workshops and seminars across the country on diverse topics related to post-acute and long-term care. Published in 2016, she authored two chapters for a textbook titled Managing... Read More →
avatar for Patricia Bach, PsyD, MS, RN

Patricia Bach, PsyD, MS, RN

Patricia Bach, PsyD, RN is a consulting clinical gero/neuropsychologist in Roseville, California and active AMDA member for the past nine years. She currently serves on the Boards of CALTCM and ABPLM, and is president of Psychologists in Long-Term Care.


Saturday March 24, 2018 4:00pm - 5:30pm MST
Austin 4-6
  Professional Development

4:00pm MST

SA20 | Making it Happen: Research Updates on Cultural Challenges to Antimicrobial Stewardship in PA/LTC
The session will present updates and outcomes from research about antimicrobial stewardship in PA/LTC settings, including cultural facilitators and barriers to improving antibiotic use and ongoing work that promotes antimicrobial stewardship as part of a culture of safety. Outcomes, challenges, and lessons learned shared in this session can support attendees seeking to innovate antimicrobial stewardship in their buildings.

Learning Objectives:
(1) Recognize features of community PA/LTCs settings that appear to correlate with lower rates of overall antibiotic use.
(2) Discuss outcomes from research that supported PA/LTC settings in using their own data and forming collaborative antimicrobial stewardship teams.
(3) Explain the relevance of implementing antibiotic stewardship as a part a culture of safety that includes leadership, administration and front-line staff.

Speakers
avatar for Robin Jump, MD, PhD

Robin Jump, MD, PhD

Robin Jump, MD, PhD, is an Infectious Disease physician at the Louis Stokes Cleveland Veterans Affairs Medical Center and Assistant Professor of Medicine at Case Western Reserve University.  She has research support from the VA and AHRQ.  Her long-term academic interests are to... Read More →


Saturday March 24, 2018 4:00pm - 5:30pm MST
Texas 1-2
  Research
 
Sunday, March 25
 

6:30am MST

SU2 | Red Eye Rounds: Clinical Quandaries
This breakfast panel is an opportunity for attendees to engage leaders in medical direction in a dialogue on best practices. The focus of this panel is on geriatric clinical care and management from a clinical perspective.

Learning Objectives:
(1) Discuss the newest trends and developments in clinical care of the frail elderly.
(2) Implement recommendations for best practices in clinical medicine for the frail elderly.

Speakers
avatar for David Nace, MD, MPH, CMD

David Nace, MD, MPH, CMD

David Nace, MD, MPH, CMD, is an Associate Professor of Medicine in the Division of Geriatric Medicine at the University of Pittsburgh. He serves as the Director of LTC and Influenza Programs for the division and as Chief of Medical Affairs for UPMC Senior Communities. Dr. Nace chairs... Read More →
avatar for Timothy Gieseke, MD, CMD

Timothy Gieseke, MD, CMD

Timothy Gieseke, MD, CMD, is a past president of CALTCM, the state AMDA chapter, the immediate past chair of the CALTCM Education committee and a past member of the AMDA Public Policy Committee. He is an Associate Clinical Professor for UCSF and teaches nursing home medicine, palliative... Read More →
avatar for Peter Winn, MD, CMD

Peter Winn, MD, CMD

Peter Winn, MD, CMD, is a Professor at the University of Oklahoma College of Medicine, Department of Family Medicine, and Oklahoma regional medical director for VistaCare Hospice.


Sunday March 25, 2018 6:30am - 8:00am MST
Texas 1-2
  Clinical Medicine