Governance













Picture of House of Delegates Chairperson
Edward Warren, MD, CMD
State Network News
August 2006, Issue 59
Front Page: HOD Chair's Message
Message from Executive Director, Lorraine Tarnove
Taking Steps to Engage Futures Participants
State Chapter Resources at Your Fingertips
Revised State Chapter Handbook is Online
A Partnership that Works
Advocating Your Cause in the State Legislature
CMS Announces Payment Increase for Skilled Nursing Facilities
Upcoming Chapter Meetings
Printable Version of This Issue
E-mail Your Articles

What better way to disseminate information to other AMDA chapters than to include an article in State Network News (SNN)?

If you would like to include an article in an upcoming issue, please e-mail it along with permission to reprint to Nicole Germain, Membership amd Communications Coordinator, at ngermain@amda.com.

State Chapter Meetings

Click here for a listing of state chapter meetings.

Keep National Updated
Please submit your annual meeting report and update your state chapter contact information if there have been changes. Also, be sure to tell us about any upcoming state chapter meetings and post the information on www.amda.com.

Download PDF version of the newsletter.

Message from AMDA's House of Delegates Chair

AMDA's House of Delegates (HOD) does not rubber stamp resolutions, not even those from the Board. At the March HOD meeting, resolution F06 "Position Statement on Oversight of the Medical Director in their Role as Attending Physician", introduced by the AMDA's Board of Directors, failed to pass. The resolution addressed the dual role of medical directors who also serve as attending physicians in the nursing facilities that they also serve as medical directors. Delegates from rural areas felt that there was nobody else in their community who could perform such reviews independently.

The performance review resolution was reconsidered by the board and a work group with representation from the states, chaired by Keith Krein MD, CMD, was convened to review the resolution. "Our intent in moving forward with this resolution is not to be proscriptive, restrictive or detailed in language," said Dr. Krein. With this in mind, the group went about their work, with three guiding principles:

  1. reconfirm support for the Medical Director's leadership role in developing a system for "Performance Review" in concert with prior AMDA Position Papers and F-Tag 501
  2. acknowledge that such a review includes all practitioners (e.g., the Medical Director is not exempt when serving in the valuable dual role as both attending physician and Medical Director) and,
  3. acknowledge that the process may look different in various settings based on demographics, geography and availability of resources (e.g. details to be worked out at the local level via the quality improvement process).

Fittingly, when the work group met, a number of concerns were presented that indicated the group's strong commitment to the review process. The defeated resolution created the illusion of conflict of interest where perhaps none existed, and lacked latitude in effective implementation. Simple chart review has not been proven to be especially effective in improving patient care.

In the months to come, the work group will re-draft the resolution using historical AMDA position papers such as the Role and Responsibilities of the Medical Director in the Nursing Home and the Tool Kit for Managing Attending Physicians. The group also will look to the State Operations Manual, Guidance to State Surveyors, and F- Tag 501.

The revised resolution will be resubmitted to the board and then forwarded for consideration to AMDA's House of Delegates. The tremendous dedication and commitment by the work group shows that the resolution process is something AMDA can be proud of. Members of the performance review work group include: Keith Krein, MD, CMD, (chairperson); Jacob Dimant, MD, CMD; Ralf C. Habermann, MD, CMD; Mark Leenay, MS, MD, CMD; Karyn Leible, MD, CMD; Susan M. Levy MD, CMD; Michael E. Maddens, MD, CMD; David F. Polakoff, MD, MSc, CMD; Dennis L. Stone, MD, MBA, CMD; Eric Tangalos, MD, CMD; Edward S. Warren, MD, CMD; and Kathleen M. Wilson, PhD (staff liaison).

Resolutions are needed from the state chapters to bring frontline issues to our attention at the national level. As you face problems AMDA might be able to help with, put your ideas down and develop resolutions for next year. Think carefully about the wording and be sure they are able to be implemented. The AMDA staff is also a great resource in such matters. You may also contact me at e-warren@att.net.

Edward S Warren MD, CMD
Chair, House of Delegates


In This Issue of State Network News:


Message from Executive Director, Lorraine Tarnove

Quality Initiative Launches September 29th - State Leaders Invited

Taking Steps to Engage Futures Participants

The AMDA Foundation Futures Program is a unique opportunity that exposes physician, residents and fellows with an interest in geriatrics to the numerous prospects in long term care. To further cultivate their interest in geriatrics, the State Chapters can take steps to engage these participants in their local chapters.

State Chapter Resources at Your Fingertips

Being that AMDA is a democratic organization governed by a board of directors that is elected by a House of Delegates, with delegates from 41 state chapters; we felt that placing the state chapter resources under Governance on the Web site made the most sense. .

Revised State Chapter Handbook is Online

AMDA is proud to announce that the revised State Chapter Handbook is available online at www.amda.com/governance/chapters/guides.cfm.

A Partnership that Works

As part of our ongoing Best Practices series, State Network News interviewed Robert J Sullivan Jr., MD, CMD, a member of the North Carolina Medical Directors Association and the Medical Advisor for North Carolina since 2003. In the following interview he discusses how North Carolina Medical Directors Association worked to established a partnership with the State and how his work has improved the survey process for all those involved.

Advocating Your Cause in the State Legislature

AMDA has provided state chapters with updated state legislative information via AMDA's Web site.

CMS Announces Payment Increase for Skilled Nursing Facilities

On July 27, 2006, the Centers for Medicare and Medicaid Services announced a 3.1% increase in payments, totaling $560 million, to the skilled nursing facility prospective payment system.

AMDA Contacts for State Chapter Business:
Membership and Communications Department (410) 992-3118
Gov't & Public Affairs Department (410) 992-3145

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