In July 2016, Apex Rehabilitation and Healthcare, a 195-bed skilled nursing and rehabilitation facility in South Huntington, took the unusual step of hiring infectious disease specialist Anne Sacks-Berg, MD, FACP, as Executive Medical Director. This role is strictly administrative; Dr. Sacks-Berg sees no patients and does not practice clinical medicine. Instead, she is focused on the quality of care that is rendered to residents.
One of Dr. Sacks-Berg’s main areas of focus has been what she terms “treating in place.” Nursing home residents are often older and sicker than the general population. Too often, they ricochet between the nursing facility and hospital, usually for treatment of symptoms that relate to an underlying health issue such as congestive heart failure.
But the transfer between the facility and the hospital and back again is not always in the best interest of the patient. It can be unnecessarily disruptive, not to mention costly, and often provides little or no long-term benefit.
“I look at each patient who was sent out, to see if there was something we could have done to keep them in the facility and treat them in place,” Dr. Sacks-Berg said. “Many times, there is.”
Her work involves coaching and training the nursing staff and medical staff to evaluate changes in patients’ conditions, and to recognize when it is advisable to treat them within the facility. As part of this project, Apex has also recently hired additional clinical staff, including physicians and nurse practitioners, who are on-site into the evening hours to help evaluate and treat patients rather than sending them to the hospital.
Another of Dr. Sacks-Berg’s initiatives is developing an antibiotic stewardship program to ensure that patients receive the right drug, at the correct dosage, for the appropriate duration of time. This scrutiny helps to decrease unnecessary antibiotic use which in turn helps prevent antibiotic resistance.
Dr. Sacks-Berg supports the idea of patients and families taking an active role in the care that is provided at Apex. Toward this end, she has fostered the development of the Family Council. This group meets monthly to discuss policies, learn about timely topics such as advanced directives, and hear presentations from Apex experts. Importantly, the Family Council, while supported and encouraged by Apex, is self-run and self-directed, allowing participants to determine which issues are the most relevant to them and their loved ones.
Stepping into this new role has given Dr. Sacks-Berg the opportunity to interact with staff at every level at Apex. She gives the entire team extremely high marks, starting with the doctors, nurses and certified nursing assistants who are the front-line caregivers.
“A lot of folks have been here for years and years,” she noted. “They care about each other and the residents.”