April 2024
Increased Responsibilities for Pennsylvania Medical Directors Includes CME
By Daniel Haimowitz, MD, CMD and Paula Sanders, Esq.
 
The Pennsylvania Department of Health substantially rewrote its regulations for skilled nursing facilities (SNFs), and most of those new requirements went into effect on July 1, 2023. In amending the regulations regarding the qualifications and duties of physician medical directors, the Department signaled its increased expectations for medical directors and their involvement with the SNFs they serve. 
 
The revised regulations expand the medical director’s responsibilities beyond those already required and now include:

  • Ensuring the appropriateness and quality of medical care and medically related care.
  • Assisting in the development of educational programs for facility staff and other professionals.
  • Working with the facility’s clinical team to provide surveillance and develop policies to prevent the potential infection of residents in accordance with infection control requirements.
  • Cooperating with facility staff to establish policies for assuring that the rights of individuals are respected.
  • Supporting and promoting person-directed care such as the formation of advance directives, end-of-life care, and provisions that enhance resident decision making, including choice regarding medical care options.
  • Identifying performance expectations and facilitating feedback to physicians and other health care practitioners regarding their performance and practices.
  • Discussing and intervening, as appropriate, with a health care practitioner regarding medical care that is inconsistent with current standards of care.
  • Assisting in developing systems to monitor the performance of health care practitioners, including mechanisms for communicating and resolving issues related to medical care and ensuring that other licensed practitioners who may perform physician-delegated tasks act within their scope of practice.

The new regulations now include that along with holding a Pennsylvania physician license, medical directors must complete four (4) hours annually of continuing medical education (CME) pertinent to the field of medical direction or post-acute and long-term care medicine. This education is necessary to help the medical director prepare for and fulfill their increased regulatory responsibilities. Surveyors will be looking to the SNF for acceptable proof that its medical director has completed this annual training. SNFs and their medical directors should review and revise their written agreements to ensure compliance with these new requirements and expectations.

There is no specific list for obtaining these credits but there are general types of Certified Medical Director (CMD) credits that are accepted for both clinical and management credits. There are American Board of Post-Acute and Long-Term Care Medicine (ABPLM) pre-approved CMD management credits which can be found at https://paltc.org/certification. The AMDA catalog contains a listing of current programs which have been pre-approved by the ABPLM for credits and can be accessed online at https://apex.paltc.org/page/catalog,

Management topics related to the management and leadership responsibilities in the post-acute and long-term care settings should be accepted by the state. Management credits can come from such topics as: billing and coding, communications with patients and staff, ethics, risk management, QI, leadership, cultural diversity, regulations, or other topics that pertain to the management responsibilities of the post-acute and long-term care Medical Director.

Proof of this educational requirement may include copies of the CME certificate or a registration/attendance confirmation form. Attending the PMDA 2024 Annual Spring Symposium on May 10 2024 at the Wyndham Resort and Convention Center in Lancaster is an excellent opportunity to meet this new obligation. 

This article does not offer specific legal advice, nor does it create an attorney-client relationship. You should not reach any legal conclusions based on the information contained in this article without first seeking the advice of counsel. Moreover, any views or opinions presented in this article are solely those of the authors and do not necessarily represent any policy or position of PAMED, PMDA, AMDA, its affiliates, and members.
PMDA Speakers Bureau
Sign Up NOW to Share Your Knowledge and Elevate Your Profile!
 
At PMDA, we continually strive to find ways to enhance our community’s knowledge and skills. It is this spirit that we are excited to extend this invitation to you to become a member of our Speakers Bureau. This is your opportunity to influence, inspire, and lead in the PALTC space!
 
We are looking for members who are passionate about PALTC, eager to share their knowledge, and able to communicate effectively with diverse audiences. Whether you are a seasoned speaker or looking to give your first professional talk, we believe your voice and presentation have the power to make a significant impact.
 
Please click here to express your interest, submit a brief bio, and outline your areas of expertise and/or proposed topics. We will review all submissions and contact selected members to discuss matching speaking opportunities when they arise.
 
Questions or need further information? Please don’t hesitate to contact us at pmda@pamedsoc.org.
 
Contribute to the richness of the PATLC community and sign up for the PMDA Speakers Bureau today!
Save The Date!
PMDA Spring Symposium Checks ALL the Boxes

Plan to join PMDA for its fifth annual Spring Symposium, May 10, 2024, in Lancaster at the Wyndham Resort and Convention Center. Our Education Committee has assembled a tremendous line-up of Pennsylvania and national experts ready to share their insights and expertise in this day-long program focused on sharpening your clinical and administrative skill set.

After breakfast and time with our exhibitors, the morning begins with Dr. Rollin Wright, Associate Professor of Medicine, Penn State Health-Hershey Medical Center Division of Geriatric Medicine and her session on “Managing the High-Risk Nursing Home Admission.” Dr. Wright will focus on enhancing transitional care for long-term care residents, particularly around the critical juncture where these individuals require transfer between nursing facilities and emergency departments.  Session attendees can expect to come away with a better understanding of the barriers that limit optimal care in this context and acquire skills to improve collaboration between nursing facility providers and emergency department providers.

In “Common Arrhythmias in the Elderly,” presenter Michael Desiderio, MD, Medical Director of Cardiology at UPMC North Central, will help attendees acquire the skills to identify and discriminate between different forms of brady or tachyarrhythmias, understand the most appropriate testing based on each arrythmia, and know when to refer to cardiology/ electrophysiology. Dr. Desiderio holds board certifications in internal medicine, cardiovascular disease, adult echocardiography, nuclear cardiography and cardiac computed tomography. In his current role as medical director, Dr. Desiderio focuses clinical efforts in advanced imaging to bring cardiac diagnostics to rural areas and quality improvement initiatives to improve access and cardiovascular care.

Have you thought about how you plan to encourage and strengthen your practice’s opportunities and pathways for the career development of your CNAs? It’s not too late to let Erin Ulrich, a nurse with more than 20 years of experience across the full spectrum of health care settings, share the importance of personal growth for these pillars PALTC. Their nurturing can lead to the potential expansion of the healthcare workforce. Ms. Ulrich is the Regional Educator overseeing the three Nurse Aide Training Programs UPMC offers in the North Central Region.

After the energizing break with PMDA’s exhibitors, the morning’s educational sessions continue with a deep dive into the “Management of Chronic and Acute Congestive Heart Failure in Nursing Homes,” lead by Dr. Nicole Osevala, Chief of Geriatric Medicine and Medical Director for Penn State Health Post Acute Care Service. Dr. Osevala will review the prevalence and general impact of heart failure in nursing homes and the opportunities to optimize the components of a heart failure management program in SNFs.

Dr. Michael Danielewicz is an Assistant Professor in the Divisions of Geriatric Medicine and Palliative Care in the Department of Family and Community Medicine at Thomas Jefferson University, and he has a keen interest in LGBTQIA+ health and wellbeing. He is the inaugural Director of Pride Care at Jefferson, the first-in-the-nation program dedicated to care to LGBTQIA+ older adults. His session, “Palliative Care Across the Long-Term Care Spectrum” will use case-based learning to review the core concepts of palliative care and to gain knowledge of affirming, competent care practices that promote inclusivity. 

The “Long-Term Care Medicine Forum,” an ask the experts panel session featuring Drs. Thomas Lawrence, Nicole Osevala, and David Nace, will close out the morning programming and afford attendees the opportunity to ask ANYTHING! Bring your questions, whether clinical challenges, regulatory issues, administrative issues, or quality improvement, and gain a better understanding and comfort level with managing the wide range of challenges seen in the daily practice of LTC Medicine. 

Media coverage of opioid users often oversimplifies, leading to stereotypes. These stereotypes influence our perceptions, especially regarding opioid use for managing pain. “Pain & Prejudice: Chronic Illness & The Opioid Crisis,” presented by Carson Wagner the founder and Director of the ViDS Effects Laboratory, a dedicated research facility for media effects experimentation in the E.W. Scripps School of Journalism, will explore ways to reduce the impact such stereotypic depictions have on treatment decision. He will help attendees understand how stereotypes are formed, gain an awareness of their own subconsciously held prejudices, and learn about what the research and theory show can and can’t be done to decrease prejudice in diagnosis and treatments. 

“Substance Use Disorder in Older Adults: Navigating Treatment in SAR/LTC Setting,” our second session of the afternoon, features Dr. Jennifer Moyer, a family medicine, geriatric, and addiction medicine physician who spends her clinical time caring for those with substance use disorders in the outpatient, inpatient, and SAR/LTC settings. Her session will review screening guidelines for substance use disorders and boost your understanding of FDA approved medications for substance use disorders.

Learning the signs and symptoms of elder abuse and being familiar with the reporting system are critical to reversing its under-recognition and under-reporting. Join Dr. Nataliya Dementovych, a Medical Director of Geriatrics at Lansdale Jefferson Health and a practicing geriatrician at the Foulkeways at Gwynedd and The Hill at Whitemarsh, as she delves into the types and warning signs of elder abuse, its long-term effects, the reasons for its under-reportage, and the knowledge needed to prevent it.  

No PMDA meeting would be complete without a Public Policy Update from the dynamic duo - Dr. David Nace, MD, MPH, CMD, Associate Professor and Chief of Geriatric Medicine at the University of Pittsburgh and an AMDA and PMDA past president and AMDA’s Senior Director of Advocacy and Strategic Partnerships, Alex Bardakh. Learn about the state and national policies on the horizon that will impact your practice and be ready to implement the changes needed to meet new requirements.

Following the afternoon refreshment break with our exhibitors, Dr. Thomas Lawrence will wrap up the day’s education with “Clinical Issues in Nursing Facility – Emergency Department Transitional Care.” Dr. Lawrence, a PMDA past president, is board certified in internal medicine and geriatric medicine and is the System Medical Director of Geriatric Medicine and Long-Term Care for the five hospital Main Line Health System in suburban Philadelphia. His session will focus on managing acute changes in condition using strategies that create a “we got this” safety culture with the collective aim of preventing hospital transfers, treating acute changes in condition in place and proactively identifying residents in risk of hospital transfers/readmissions.

Register today for PMDA’s Spring Symposium. You don’t want to miss the education, networking, cutting edge exhibitors, and camaraderie that have PMDA meetings checking all the boxes! 
Refer a Colleague

Do you know someone who would benefit from speaking with a PMDA representative? We would be happy to reach out to them!
 
Follow the link below to get started!
Job Bank

Private Practice! We are looking for a motivated physician to replace a retiring physician in our two physician and one CRNP suburban practice which is part of Medical Associates of the Lehigh Valley, an independent group aligned with the Lehigh Valley Hospital Network. 

Since this is private practice, you are free to decide your own schedule. Our office in North Catasauqua offers about a 60/40 split between our office and two nursing homes and two personal care homes.
There is the opportunity to become a shareholder with the group in two years. 

There are not many jobs out that offer this type of flexibility anymore!
Contact Sean Heffelfinger, MD at sheffel@rcn.com if interested.
Still NOT a PMDA Member?

You can become a member of PMDA by clicking on the membership application below.

To pay for your membership dues, you may either mail a check to PMDA (400 Winding Creek Blvd., Mechanicsburg, PA 17050) or complete the credit card/billing information in the membership application or call Lauren Newmaster, Finance Coordinator, at 833-770-1547 to pay via credit card over the phone.
If you have any questions about membership, please contact PMDA at pmda@pamedsoc.org.
Access PALTC24 Recordings

Missed out on PALTC24 (AMDA’s annual conference)? Don't worry! Gain access to audio-synced slides for the majority of their 60 and 90-minute sessions, along with the General Sessions, by purchasing the conference recordings. Plus, you'll have the convenience of downloading session handouts. Learn More
Register for More of a Good Thing and Leading With Purpose

The next edition of More of a Good Thing: A Framework to Grow and Strengthen the PALTC Careforce will take place on Thursday, April 11, at 4:00 PM ET. The topic is Feedback in Action. Register now.
 
You can also sign up now for the next Leading With Purpose: 8 Strategies for Engaging Your Careforce being held April 18 from 4:30-5:00 PM ET. The topic is Crowdsourcing the Collective Intelligence of Your Team.
AMDA Launches New Member Forum

Not only did AMDA launch a new website in February, but they also launched a new Member Forum. This is your exclusive community to solicit advice, share expertise, exchange ideas, and most importantly, connect with other members. Not a member of AMDA? Join today!
Medical Director Certification

Are you ready to take your career as a medical director to new heights? Elevate your professional standing and demonstrate your comprehensive understanding of the role by becoming a Certified Medical Director (CMD). This prestigious certification not only showcases your expertise and dedication but also opens doors to exciting opportunities and recognition within the industry. Learn More
Covid-19 Recertification Grace Period Ends June 30, 2024

If you missed the April 1 recertification application deadline, contact ABPLM at cmd@paltc.org or by calling 410-992-3115. Don't let your CMD credential lapse!
 
Maintaining your CMD credential requires documentation of 60 clinical CME credits and 60 management CME credits. A minimum of 30 credits must come from pre-approved CMD Management credits. The PALTC24 conference recording package provides you with most of the credits you’ll need to recertify!