2011 Annual Conference

Mar 24, 2011 ‐ Mar 27, 2011


The information provided in this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

Contact Information: For questions about this CME activity contact AMDA’s Education Department at 410-740-9743 or at education@amda.com

Instructions for Course Participation

  • Click on the session title to review the materials on Terms of Use and Disclaimer statements, accreditation information, target audience, learning objectives, and disclosure information
  • Complete the entire self-study activity (viewing the PowerPoint presentation and listen to the audio recording in its entirety)
  • Complete and submit the self-assessment and evaluation/CME claim form
  • Print out CME certificate
  • The online library awards credits for sessions ranging from 1 to 3.5 hours. Each activity should take you approximately the number of hours to complete as credits which are awarded for that activity, (e.g. for 1.5 credit hours awarded, the completion of the activity should take approximately 1.5 hours to complete.)

BY USING THIS SITE YOU AGREE TO ABIDE BY OUR TERMS OF USE AGREEMENT

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SELF-ASSESSMENT ACTIVITIES

Sponsored by the American Medical Directors Association (AMDA)

Release Date: 06/2011      Valid through: 06/2014

Click here for a list of Management and Clinical credit designations.

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation
The American Medical Directors Association designates this educational activity for a maximum of 133 AMA PRA Category 1 Credit((s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDA Certification Program (AMDCP) Credit Designation
This seminar has been approved for a total of 133 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD). 99.5 credits have been designated as Management education credits and 33.5 hours have been designated as Clinical education credits. The AMDA CMD program is administered by the American Medical Directors Certification Program. Each physician should claim only those hours of credit actually spent on the activity.

ACCME STANDARDS FOR COMMERCIAL SUPPORT
As an ACCME accredited provider of CME, AMDA adheres to all elements of the ACCME Standards for Commercial Support?. Individuals in a position to control the content of this education activity were required to disclose all relevant financial relationships with any commercial interest to AMDA. Disclosures were reviewed by the AMDA Education Department to identify any conflicts of interest and methods of conflict resolution were conducted for each of the identified conflicts. Individual presenter’s disclosures can be found within the CME information for each session.

PROGRAM PLANNING 
AMDA wishes to gratefully acknowledge the Program Planning Committee for their dedication to AMDA education and Long Term Care Medicine - 2011.

2011 Planning Committee Members
Matthew S. Wayne, MD, CMD (2011 Program Chair)
Heidi K. White, MD, CMD (Vice Chair)
Priscilla F. Bade, MD, FACP, CMD
Paul Drinka, MD, CMD, AGSF
Mary P. Evans, MD, CMD
Rosina M. Finley, MD, CMD 
Thomas Rex Flygt, MD, CMD
Aida Wen, MD, CMD
Suzanne Gillespie, MD 
William N. Hovland, MD, CMD
Robert G. Kaplan, MD, CMD, FACP
Karl Steinberg, MD, CMD 
Carl Suchar, DO, CMD, PA
Aida Wen, MD, CMD
Bonnie Wirfs, MD, CMD

According to AMDA and ACCME policy, all those in a position to control content are required to disclose any relevant financial relationships. 

Suzanne Gillespie, MD – AMDA Pfizer QI: Grant Recipient 
Karl Steinberg, MD, CMD – GlaxoSmithKline, Boehringer Ingelheim, Forest Pharmaceuticals, Inc.: Speakers Bureau; California Association of Health Facilities, California Association of Long Term Care Medicine: Advisor; Watson Pharmaceuticals, Inc., Barr, Pfizer: Stockholder
Matthew S. Wayne, MD, CMD – Forest Pharmaceuticals, Inc., Boerhringer Ingelheim Pharmaceuticals, Inc.: Speakers Bureau 
Heidi K. White, MD, CMD – Amgen: Principle Investigator; Merck: Co-Investigator

All other Program Committee members actively involved in planning reported they have nothing relevant to disclose. Faculty disclosure information is provided with the individual session information for each session on the CME information page.

Target Audience:
Medical Director, Attending Physician, Nurse (NP, DON, RN, CNA), Administrator, Consultant Pharmacist, Therapist

Standard: $395.00

Products

The LTC Continuum: What is it and How Do I fit in?

Preview Available

The LTC Continuum: What is it and How Do I fit in?

Mar 24, 2011 8:00am ‐ Mar 24, 2011 8:45am

Standard: $24.00

Update on Billing and Coding

Preview Available

Update on Billing and Coding

Mar 24, 2011 8:00am ‐ Mar 24, 2011 5:00pm

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates
this educational activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of 3.5 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
Choosing the correct CPT code for Evaluation and Management Services performed in settings where providers perform such services is frequently confusing and challenging to physician and non-physician providers. However, the process for correctly choosing the appropriate code is straightforward. Extensive resources are available to assist providers in this process. This session will provide detailed information about the correct process for accurately establishing the appropriate CPT billing code for services provided in a variety of settings, including the nursing home, assisted living facilities, and patients' homes.

Learning Objectives(s):

  • Define the process of selecting the appropriate Evaluation and Management codes for services provided in the nursing home, assisted living and home settings.
  • Delineate the CPT codes and supporting documentation used for billing E&M services rendered in these settings.
  • Discuss coding and billing issues related to the use of physician extenders (physician assistants, nurse practitioners, etc.).
  • Define resources available to practitioners for use in the coding and billing processes.

Speakers(s):
Alva S. Baker, III, MD, CMD; Charles A. Crecelius, MD, PhD, CMD; Leonard Gelman, MD, CMD

Disclosure(s):
Alva S. Baker, III, MD, CMD has no financial disclosures to report.
Leonard Gelman, MD, CMD has no financial disclosures to report.
Charles A. Crecelius, MD, PhD, CMD has no financial disclosures to report.

Speaker(s):
Standard: $24.00

AMDA Mental Health Workgroup Intensive Course on Psychiatric Issues in Long Term Care

Preview Available

AMDA Mental Health Workgroup Intensive Course on Psychiatric Issues in Long Term Care

Mar 24, 2011 8:00am ‐ Mar 24, 2011 5:00pm

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates
this educational activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of 3.5 Clinical credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
Three cases will be presented, and an update and review of the associated topics will be followed by group discussion. The first case will discuss an admission of a resident with a primary chronic and severe psychiatric diagnosis, e.g. Schizophrenia. The second case will be one of dementia with neuropsychiatric symptoms. Finally, a resident with a complicated mixture of depression and anxiety will be presented. The session will introduce MDS 3.0 as it relates to psychiatric diagnoses.

Learning Objectives(s):

  • Describe how the changes between MDS 2.0 and 3.0 foster the use of standardized instruments to quantify psychiatric symptomatology, which can prove helpful in making treatment decisions.
  • Discuss which circumstances should prompt you to ask for psychiatric consultation when managing a resident in long term care with a psychiatric illness.
  • Review the evidence base for both nonpharmacological and pharmacological management of dementia with neuropsychiatric symptoms.
  • Demonstrate comfort in recognition and management of overlap syndromes between depression and anxiety.

Speakers(s):
Jay S. Luxenberg, MD; Lori Bright-Long, MD, CMD; Miodrag Ristich, MD, CMD; Ladislov Volicer, MD, PhD; Eric Tangalos, MD, CMD; Leo Borrell, MD; Edward S. Warren, MD, CMD

Disclosure(s):
Miodrag Ristich, MD, CMD has no financial disclosures to report.
Ladislov Volicer, MD, PhD has no financial disclosures to report.

Speaker(s):
Standard: $24.00

MDS 3.0's Care Area Assessment and the AMDA Care Process - Why You Need to Care!

Preview Available

MDS 3.0's Care Area Assessment and the AMDA Care Process - Why You Need to Care!

Mar 24, 2011 8:00am ‐ Mar 24, 2011 11:30am

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates
this educational activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of 3.5 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
With the implementation of MDS 3.0, and the new Care Area Assessment (CAA), facilities will need to show they are using evidence-based and expert endorsed resources. Appendix C in the new MDS manual references the AMDA guidelines. This interactive workshop will familiarize the attendee with the MDS 3.0 Care Area Assessment process and then, using several AMDA guidelines, show how to use the guidelines as the care process for the CAA.

Learning Objectives(s):

  • Describe the purpose and intent of the MDS 3.0 Care Area Triggers (CATs) and Care Area Assessments (CAAs)
  • Discuss the differences between the MDS 2.0 Resident Assessment Protocols (RAPs) and MDS 3.0 CAAs
  • Identify how to use the 4 stages of the care process within the AMDA CPGs to conduct a thorough assessment of the resident to meet CAA requirements
  • Design a plan for implementing strategies using AMDA’s evidence-based CPGs as the care planning process for working through a CAA

Speakers(s):
Jackie Vance, RNC, CDONA/LTC; Christie L. Teigland, PhD

Speaker(s):
Standard: $24.00

Palliative Care Part I: Clinical and Ethical Considerations

Preview Available

Palliative Care Part I: Clinical and Ethical Considerations

Mar 24, 2011 8:00am ‐ Mar 24, 2011 11:30am

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates
this educational activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of 3.5 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
This session provides an overview of practical approaches to ethical decision-making. Evaluating benefits and burdens of artificial nutrition and hydration, encouraging spiritual and emotional considerations in end of life care, collaboration between nursing homes and hospice, and organizational changes to improve end of life care will be discussed.

Learning Objectives(s):

  • Define palliative care as it relates to each resident within the long term care continuum.
  • Examine a systematic approach to assessing and managing pain and non-pain symptoms.
  • Describe comprehensive assessment and treatment of pain in the nursing facility.
  • Enhance communication with patients, families, and caregivers regarding goals of care and advanced care planning.

Speakers(s):
William D. Smucker, MD, CMD; Peter Winn, MD, CMD; Amy M. Corcoran, MD

Disclosure(s):
William D. Smucker, MD, CMD has no financial disclosures to report.
Amy M. Corcoran, MD has no financial disclosures to report.
Peter Winn, MD, CMD has no financial disclosures to report.

Speaker(s):
Standard: $24.00

The Medical Director's Role in Improving and Reforming Long Term Care

Preview Available

The Medical Director's Role in Improving and Reforming Long Term Care

Mar 24, 2011 8:00am ‐ Mar 24, 2011 11:30am

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates
this educational activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of 3.5 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
This session will review in depth the medical director's key role in helping improve and reform individual nursing homes and nursing home care in general. It will refer to the framework presented at length in a series of articles published in JAMDA. It will focus in particular on the concepts of biologically sound care, the care process, the application of clinical expertise, the medical director's role in a sound system of care that is most likely to attain desirable quality goals, and the physician and medical director roles in promoting ""evidence-based"" care and helping facilities move away from some common but questionable practices. It will offer the medical director and attending physician specific tips and potential actions to influence clinical policies, optimize care in their patients, and help elevate the standard of care in their facility and community.

Learning Objectives(s):

  • Discuss the medical and biological basis for high quality long-term care, and its relevance to the care process in nursing homes.
  • Describe the key elements of clinical expertise and "evidence-based care" and be able to assess whether and to what extent they are present in specific situations in the nursing home.
  • Identify the key elements of a facility that is capable of providing high quality care and use this in fulfilling the medical director quality assurance role.
  • Identify the basis of a number of current common practices in long-term care and be able to help facilities distinguish and implement clinically sound practices.

Speakers(s):
Steven A. Levenson, MD, CMD

Disclosure(s):
Steven A. Levenson, MD, CMD has no financial disclosures to report.

Speaker(s):
Standard: $24.00

Hospital and Nursing Homes: Slowing the Revolving Door

Preview Available

Hospital and Nursing Homes: Slowing the Revolving Door

Mar 24, 2011 8:00am ‐ Mar 24, 2011 11:30am

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates
this educational activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of 3.5 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
This session describes a continuous quality improvement process updating transfer processes designed for convenience, patient safety and associated with low hospital readmission rates. Methods adopted by nursing home administration and attending physicians insuring completeness of the process will also be presented. In addition, it will define the scope of the issue of rehospitalization in subacute care nationally and describe an innovative program to reduce transfers out to the hospital. Examples of how electronic medical records are being used to educate patients and families on discharge will be discussed.

Learning Objectives(s):

  • Discuss the nature of rehospitalizations nationally, the costs to our health care system, and how some organizations have successfully lowered rates.
  • Describe an innovative program that has lowered rehospitalization rates using: 1) Identification of high risk patients and early goals of care discussions 2) Automatic palliative care team consult 3) Team Improvement for the Patient and Safety (TIPS) multidisciplinary conferences for root cause analysis 4) Project RED on discharge home.
  • Examine how online medical record can be used to empower patients and demonstrate teach back of both patient and family prior to discharge from a subacute unit.
  • Discuss how team culture can be changed by bimonthly case reviews of patients that have been transferred out to the hospital.
  • Evaluate how convenience and patient safety can be built into a hospital-to-nursing home transfer system.
  • Describe the community-wide design and input from both hospital and nursing homes necessary for successful transfer processes.
  • Discuss how nursing homes and their attending physicians can control the completeness of transfer materials.

Speakers(s):
Randi Berkowitz, MD, CMD (Moderator); Sharon Verney, NP; Robert J. Schreiber, MD, CMD; David Sandvik, MD, CMD; Priscilla F. Bade, MD, CMD

Disclosure(s):
Randi Berkowitz, MD, CMD has no financial disclosures to report.
David Sandvik, MD, CMD has no financial disclosures to report.
Robert J. Schreiber, MD, CMD has no financial disclosures to report.
Sharon Verney, NP has no financial disclosures to report.
Priscilla F. Bade has no financial disclosures to report.

Speaker(s):
Standard: $24.00

Complementary Approaches to Managing Pain in End-of-Life Care

Preview Available

Complementary Approaches to Managing Pain in End-of-Life Care

Mar 24, 2011 8:00am ‐ Mar 24, 2011 11:30am

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates
this educational activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of 3.5 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
This session will discuss the importance of considering complementary modalities and spiritual support of patients in end-of-life care. Supporting evidence will be presented, and the underlying basis of the methods will be explained, using Reiki as a model. The effectiveness of methods of caring in combating suffering when cure cannot be obtained will be explored.

Learning Objectives(s):

  • Discuss the importance of pain, spirituality, and human connection in end-of-life care.
  • Discuss the current evidence based support for CAM.
  • Explain the concept of ""Spiritual Energy"" underlying many complementary methods of pain relief.
  • Explore the capacity of both organized religion and non faith based spirituality t help patients facing pain and incurable illnesses.

Speakers(s):
Harold Bob, MD, CMD; Niroshi Sharlene Rajapakse, MD, CMD; Charles A. Crecelius, MD, PhD, CMD

Disclosure(s):
Harold Bob, MD, CMD has no financial disclosures to report.
Charles A. Crecelius, MD, PhD, CMD has no financial disclosures to report.
Niroshi Sharlene Rajapakse, MD, CMD has no financial disclosures to report.

Speaker(s):
Standard: $24.00

It's ALL Possible: Practical Approaches to Long Term Care

Preview Available

It's ALL Possible: Practical Approaches to Long Term Care

Mar 24, 2011 8:45am ‐ Mar 24, 2011 9:30am

Standard: $24.00

Palliative Care Part II: Clinical and Organizational Considerations

Preview Available

Palliative Care Part II: Clinical and Organizational Considerations

Mar 24, 2011 1:30pm ‐ Mar 24, 2011 5:00pm

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates
this educational activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of 3.5 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
This session presents an overview of practical approaches to communication, advance care planning, and assessment and control of pain and other distressing symptoms experienced by patients in long term care. It will define palliative care as it relates to each resident within the long term care continuum and examine a systematic approach to assessing and managing pain and non-pain symptoms.

Learning Objectives(s):

  • Describe benefits and burdens of artificial nutrition and hydration.
  • Enhance understanding of emotional and spiritual issues at the end of life.
  • Describe how hospice and nursing homes can work together productively.
  • Identify organizational barriers to improving end of life care and describe practical policies to promote better end of life care.

Speakers(s):
William D. Smucker, MD, CMD; Deborah Way, MD, CMD; Lory E. Bright-Long, MD, CMD; Anthony J. Lechich, MD, CMD

Disclosure(s):
William D. Smucker, MD, CMD has no financial disclosures to report.
Anthony J. Lechich, MD, CMD has no financial disclosures to report.
Lory E. Bright-Long, MD, CMD has no financial disclosures to report.
Deborah Way, MD, CMD has no financial disclosures to report.

Speaker(s):
Standard: $24.00
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