Dear Dr. Jeff: Our nursing home was devastated when a new resident shot himself on Christmas Eve. He had been admitted 2 days previously for rehabilitation after suffering a small stroke. He persuaded a friend to bring in his revolver — which he usually kept next to his bed at home — so he would feel “safe” surrounded by strangers. After the friend left, he... »

Dear Dr. Jeff: Do you think that medical liability reform would affect the way we care for our residents in nursing homes? Should the average long-term care physician support tort reform or should we see liability as a way to police some of our colleagues who we know are doing a poor job?

Dr. Jeff responds: The topic of liability or malpractice reform is... »

Dear Dr. Jeff:

Our state is planning to solve prison overcrowding issues and save money by transferring prisoners to skilled nursing facilities, where the costs will be federally reimbursed. I am worried about this whole process, but I know that our owners will want to fill our empty beds. I saw in a recent issue of this paper that you are involved with... »

Dear Dr. Jeff:

Our nursing home has a contract with a nearby hospice to help us provide care to terminally ill residents. But it seems that our staff and theirs are constantly squabbling. I planned to switch to another hospice that is slightly farther away, but friends tell me that it is no better. Why should professionals who give compassionate care to... »

Dear Dr. Jeff:

I was recently hired as the medical director at a facility where I had previously followed several patients. I was aware of several problems at the facility and eager to improve the quality of care, as I had already helped to do at another nursing home where I am still medical director.

But neither the administrator nor the director of... »

Dear Dr. Jeff:

I’ve heard that the federal government’s powerful Office of Inspector General came out with a report saying that skilled nursing facilities are still grossly overadministering antipsychotic drugs to our residents. In my state, California, the department of public health is initiating its own "complaint investigations" when any SNF... »

Dear Dr. Jeff:

It seems I keep hearing about increased survey emphasis on pain management in residents, yet I’m not sure what more I can do than prescribe the proper analgesics and check back that my patients’ pain is being taken seriously by nursing and facility staff. Are skilled nursing facilities and attending physicians really doing such a poor job... »