As Chair of Education for CALTCM and as a member of AMDA Public Policy Committee, I am amazed at the rapid transitions occurring in health care in our country.  Hospitals are shrinking, becoming more like the ICUs of the past, while nursing home post-acute care is becoming more like acute hospital ward medicine.  For the first time, partnerships and collaborations are developing between hospitals and their downstream providers.

by Tim Gieseke MD, CMD

The new JNC 8 (Joint National Commission) guidelines for hypertension management have raised the threshold for starting medication to manage hypertension.  These evidenced based guidelines (insert link to guidelines) now recommend raising the target for treating HBP in > 60 y/o to < 150/90 rather than the previous 140/90.  In those with diabetes or CKD (Chronic Kidney Disease), the target has been raised to < 140/90 rather than < 130/80.  In this population, there is accumulating evidence for harm if the BP is too low.  These risks include dizziness, falls, and even death.

by James Mittelberger, MD, CMD

I recently attended the farewell party for a leader that caused me to reflect on excellence. Remy Tibayan served 28 years as the administrator of Fruitvale Health Care Center, a nursing home in a low-income neighborhood in Oakland, CA. Surrounding her were dozens of an extraordinarily diverse, tearful staff -- immigrants from Africa, Asia, the Middle East, and Latin American with many from local neighborhoods.  Singing and crying together, we had forged powerful and personal bonds of love and respect in dedication to a shared mission. Many had been together for decades.