Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - News on Dr. Levine's medical and consulting practice, and reflections on our healthcare system.

Archive for 2010

Geriatrics by Legislation: The Trend Continues

In a recent blog post I pointed out some legislative initiatives that essentially make certain principles of geriatric practice required by law.  I noted how these laws can be interpreted as an effort to make up for the scarcity of practicing geriatricians, and the lack of geriatrics training for most physicians in America.   President Obama has continued this trend by signing a new Medicare regulation …Read More

Brief Reprieve from Congress for Medicare Cuts to Doctors

Earlier this month the Senate voted to postpone for one year the impending Medicare pay cuts to doctors that would have gone into effect January of 2011.  This is the latest postponement for a measure that will have deep impact on care of the elderly in America.  In a recent blog post I discussed the imminent Medicare pay cut for physicians and the impact on …Read More

Straight Talk on Reverse Staging of Pressure Ulcers

The issue of “reverse staging” or “backstaging” of pressure ulcers as they heal is often a cause for confusion, even for some experts.  With this blog post I hope to clarify things and explain why reverse staging is now discouraged when assessing wounds, and place the issue in context with the revised Minimum Data Set (MDS) 3.0 Section M: Skin Conditions, which went into effect October …Read More

Healthcare Reform Provision Helps Lawsuits Against Nursing Homes

A little known provision of President Obama’s Healthcare Reform Act is designed to help plaintiffs and their attorneys bring legal action against nursing homes for alleged neglect and abuse.  With the demographic transformation of America toward an aging society, lawsuits against nursing homes have surged.  In response some privately owned nursing homes have developed complex corporate structures that obscure who controls the facilities, making it difficult for attorneys …Read More

Photographing America’s Aging Heroes: The Tuskegee Airmen

I have been photographing Aging Across America for some time, and one of my favorite subjects is elderly veterans.  I had heard about the Tuskegee Airmen from various news articles.  These men were the first group of African American aviators to fight for America in World War II.  In a racially segregated military, these men smashed the barrier of race and helped us win the …Read More

Does MDS 3.0 Section M Avoid the Unavoidable?

The revised Resident Assessment Instrument (RAI) with the new MDS 3.0 Section M: Skin Conditions radically expands the assessment process for pressure ulcers in Medicare certified skilled nursing facilities.  In contrast to the prior version, there are data fields for improving or deteriorating pressure ulcers, ulcer measurements, and tissue type at the base of the wound.  Important issues such as “present on admission” and updated …Read More

Elder Abuse in Film: A Geriatrician’s Viewpoint

This past Halloween I stayed at home with my wife and watched old horror films.  One of them was the psychological suspense thriller, What Ever Happened to Baby Jane, released in 1962.  This is the story of two aging sisters, one of whom is paraplegic and confined to a wheelchair on the second floor of their Hollywood home.  The movie featured stunning performances by paraplegic …Read More

Geriatrics: An Endangered Specialty

On December 1, 2010, Medicare payments will be slashed by more than 21%, a cut that will severely impact physicians who practice geriatric medicine.  The result will be devastating to the 43 million American seniors who receive Medicare coverage, sharply limiting access to care in an environment that is already facing a deficit in geriatric practitioners.  A report published by the Institute of Medicine in …Read More

CMS Tightens Up Pressure Ulcer Classification in Long-term Care

Revised Minimum Data Set (MDS) 3.0 Section M: Skin Conditions greatly expands the process of skin assessment in nursing homes.  The accompanying Resident Assessment Instrument (RAI) Instruction Manual has instructions on how to identify and code pressure ulcers and other wounds using a methodology that is explicitly stated.  These instructions include the following: “If an ulcer arises from a combination of factors which are primarily …Read More

Aging Across America Visits a California Shopping Mall

Last year I read about a group of elderly men from India and Pakistan who meet daily in a shopping mall in Fremont, California called The Fremont Hub.  The article talked about the local population of northern Indian immigrants, and recounted the trials and tribulations of these elderly newcomers.  I decided that I would make these men part of my portfolio of Aging Across America, and …Read More