As of July 1, 2016, the Centers for Medicare and Medicaid Services has been requiring more detailed documentation of employee time spent in nursing homes on the job.  This initiative goes by the tasty acronym of PBJ:  Payroll-Based Journal.  Many of us medical directors have been doing this for awhile, but probably just about all of us will be doing it soon.  Nursing homes in California also now require a specific on-site audit annually to ensure that they meet the state-mandated minimum nursing staffing of 3.2 nurse hours per patient day, but this is a separate matter.

by Jay S. Luxenberg, MD, FACP, AGSF

A few years ago I received a call asking me to participate in a symposium on facilitating persons with dementia voting. My first reaction was that this had to be some sort of joke. I was expecting some version of candid camera to jump out and surprise me. After some discussion I realized that the caller was serious, and that this was in part sponsored by the American Bar Association. The proceedings of this meeting were published and are available online at no cost: The University of the Pacific McGeorge Law Review Volume 38, Issue 4 (2016) Symposium: Facilitating Voting as People Age: Implications of Cognitive Impairment. Although all the articles are interesting, I would particularly recommend one by Nina A. Kohn, Preserving Voting Rights in Long-Term Care Institutions: Facilitating Resident Voting While Maintaining Election Integrity. It outlines responsibilities of long-term care facilities concerning voting rights. It highlights the use of technology to bring the voting station to the nursing home. It discusses isolated instances of nursing homes facilitating voter fraud. It clarifies the issues around determining capacity to vote – essentially, that is not the role of long-term care staff.

by Jason Lee, MD, MPH

As a recent graduate of the VA-UCLA Geriatric Medicine Fellowship Program, I am grateful for the numerous educational programs provided by the California Association of Long Term Care Medicine (CALTCM) that advance interprofessional education and collaborative care in post-acute and long-term care (PA/LTC) settings. These programs enabled fellows to develop skills in leadership and management in geriatrics, participate in advocacy and public policy in healthy aging, and promote patient safety and quality improvement strategies in the care of older adults.

by Michael Wasserman, MD, CMD

I like to tell people that as a Geriatrician I’ve discontinued more prescription medications in my career than I’ve started.  I’ve done this without the benefit of randomized controlled trials in the population that I am used to caring for.  The demographic of 85-year-old women with multiple chronic diseases is an apt description of my typical patient population.  There have been many times that I’ve discontinued most, if not all, of my patients’ medications and had them demonstrate clinical improvement.