News
Meet Dr. Frank Randolph

Meet the CALTCM Board of Directors

Frank Randolph, M.D., C.M.D.

Frank Randolph, M.D., C.M.D, completed residency training in Family Medicine in 1984 and fellowship training in Geriatric Medicine in 1985, maintaining continuous board certification in Family Medicine and Geriatric Medicine. He serves as Geriatric section chief at Arrowhead Regional Medical Center, teaching Family Medicine and Internal Medicine residents. He has been program director for two geriatric fellowship programs (UCI, ARMC). He has considerable experience as medical director and attending physician in skilled nursing facilities. A former President of the California Association of Long Term Care Medicine, he has been a member and board member since 1985. He has also been an AMDA member and certified medical director for over 25 years.

Interview with Dr. Randolph:

CALTCM: What is your training background, practice setting and how many years have you been in practice?
Dr. Randolph: Family med residency, geriatric fellowship, and 30 plus years of practice.

CALTCM:  What are you passionate about in long term care?  How are you pursuing your passion?
Dr. Randolph:  My interests have varied over time from primary care in the nursing home, RCFEs to medical
direction in SNF, home care, and hospice settings. Of late, I have been more interested in transitional care.

CALTCM:  What advice would you give to a new graduate contemplating a career in long term care?
Dr. Randolph:  That would depend upon the individual graduate’s background, attitude, and general goals.
If you truly want a career in LTC, the first step after a primary care residency would be a one year geriatric
fellowship at a program that is strong in the LTC area you desire.

CALTCM:  What additional training do you wish you had that may help with your current practice?
Dr. Randolph:  Evidence-based concepts related to care transitions to and from the various settings
such as acute hospital, home, nursing home.

CALTCM:  How has CALTCM impacted your practice?
Dr. Randolph:  Ideas derived from the experience of attending the seminars and interacting with members has
influenced the way I approach long term care as an attending, as a teacher, and as a medical director, in diverse
ways, from both business and clinical perspectives.
 
Added Incentive to Reduce Inappropriate Antipsychotic Use 
by Tim Gieseke, MD, CMD
Chair, CALTCM Education Committee

On August 1st, the CDPH sent out the attached ALF advising us of enhanced surveyor oversight for our use of antipsychotics.  In California, we have made significant progress in this area.  As a part of CMS region 9, we have reduced the frequency of antipsychotic use in our long stay residents (>100 days) to 16.7% (excludes schizophrenia, Huntington’s and Tourette’s).  We are the second best region in the country with Alaska #1.
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SNF Readmission Penalties Announced: Is your facility prepared?
Skilled Nursing Facility Value-Based Purchasing Program
by Josh Luke
Founder, The National Readmission Prevention Collaborative
 

Included in the "doc fix" passed in April 2014, H.R. 4302, the Protecting Access to Medicare Act of 2014 (PAMA), was a value-based purchasing (VBP) program for skilled nursing facilities (SNFs). PAMA establishes an incentive pool for high performing SNF's as it pertains to preventing unnecessary hospital readmissions. The Congressional Budget Office projects the program will save Medicare $2 billion over the next 10 years.
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New California POLST in 2014: A Tool to Re-Energize our Conversations 
by Tim Gieseke, MD, CMD
Chair, CALTCM Education Committee

As a post-acute care physician, I have been concerned in the past that the language used in POLST forms I am asked to sign commonly sounds more harsh than what I would actually say when having discussions with patients about the kind of care they would like to receive in future emergencies.  Most of these discrepancies fall under Section B of the POLST, where the form uses words like “comfort” and “limited” in ways that are confusing to nurses and the public.
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Decision Guides Help Patients Make Informed Decisions
by Ellen Hickey
Program Director
Coalition for Compassionate Care of California
 

As a healthcare professional, having a conversation about goals of care and life-sustaining treatments with seriously ill patients and their loved ones can be difficult. The Coalition for Compassionate Care of California (CCCC) has developed a new set of Decision Guides that explains complex topics associated with these difficult conversations using consumer-friendly language with evidence-based information. Topics include artificial hydration, CPR, mechanical ventilation, and tube feeding.
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