CALTCM has partnered with CAHF to address common care processes that may interfere with our patient’s sleep preferences.  The focus of the CAHF Quality Subcommittee’s initiative has been the timing of medications and administration of beverages (see attachments below).  These model policies and procedures provide a flexible and safe way to modify incoming orders, including medication orders and timing, for both new admissions and also serve as a tool for adjusting these care plans for long-stay residents.  

As an in-the-trenches clinician, I have come away from each CALTCM and AMDA annual meeting with my “batteries” recharged and with new ideas for improving patient and facility care. Going to these meetings has introduced me to many thought leaders in our setting who gladly rub shoulders with attendees and make time for curbside consults.  These are truly “family” events.

“I know geriatrics, because I’ve taken care of a lot of old people.” As a geriatrician, I’ve heard this refrain my whole career from other physicians who are trying to rationalize the care they deliver to older adults.  The scope of this refrain is about to expand, and we shouldn’t be surprised to find nursing home administrators opining on clinical care delivery approaches.

In 2001 I co-founded Senior Care of Colorado.  We were a small group of six geriatricians and a couple of physician assistants working out of two clinics who provided primary care geriatrics in local nursing homes. We immediately had offers from several local nursing homes to take positions as medical directors.  Naively, we thought that these offers reflected a desire for these facilities to gain expertise in geriatrics. Realistically, they probably thought that hiring us would bring them more patients. Within a year we were under investigation from the OIG. They interviewed several nursing home administrators.