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.

Category: Publications

15 Years of Covers on The Gerontologist

This video explores my photographic work that has appeared on the cover of The Gerontologist (TG) over the past 15 years.  The Gerontologist is published by Oxford University Press, and is the flagship journal of the Gerontological Society of America, and is devoted to multidisciplinary research and education in all aspects of aging. I started publishing photos on TG back in 1996.  The subjects include friends, teachers, …Read More

Essentials Of MDS 3.0 Section M: Skin Conditions

This article was published in  Advances in Skin & Wound Care. 23(6):273-284, June 2010. This is a CME (Continuing Medical Education) article published in the June issue of Advances in Skin & Wound Care.  It gives the basics of revised MDS 3.0 specifically regarding the section on skin condition.  Those clinicians working with pressure ulcers in long-term care will need to know Section M of …Read More

Clarification Of Pressure Ulcer Staging In Long-Term Care Under MDS 2.0

This article was published in Advances in Skin & Wound Care. 23(5):206-210, May 2010. This article was co-authored by Sharon Roberson RN from the Centers for Medicare and Medicaid Services (CMS), Elizabeth Ayello RN, PhD, and myself.  Our goal was to clarify pressure ulcer staging in long-term care under the Minimum Data Set (MDS) Version 2.0, specifically with regard to blisters of the heel and …Read More

The Unavoidable Pressure Ulcer: A Retrospective Case Series

This article was published in Journal of Clinical Outcomes Management 2009 Aug;16(8):359-363  To identify medical conditions related to pressure ulcer occurrence when at-risk status is appropriately assessed and preventive measures are in place we did a retrospectice chart review in an acute care hospital. Charts were reviewed for past medical history, activities of daily living, comorbid illness, and physiologic parameters at the time of ulcer discovery.   20 …Read More

Optimizing Pressure Ulcer Care: A Checklist For System Change

This article was published in Ostomy Wound Management 2009; 55:6, p 6. Our healthcare system sought to enrich and improve strategies to assess, document, and prevent pressure ulcers and to identify key personnel to implement these strategies. An evaluation of our practices yielded the following recommendations:1. Assess policies and procedures relevant to documentation systems, risk assessment tools, prevention techniques, and skin assessment documentation along with ease …Read More

Peripheral Arterial Disease And Its Consequences: Considerations For Long-Term Care

This article was published in Annals of Long-Term Care, Volume 17, pp 1524-7929. Peripheral arterial disease (PAD) in the LTC setting has major consequences in terms of mortality, morbidity, and increased healthcare costs. Complications include pain, chronic skin ulceration, gangrene, amputation, infection, and death. In recent years, medical-legal liability for providers caring for residents with this disease has increased. PAD is complex and involves inflammation …Read More

New Opportunities To Improve Pressure Ulcer Prevention And Treatment

A Consensus Paper From the International Expert Wound Care Advisory Panel This article was published in Wounds.  Issue 9, September 2008. As part of the Deficit Reduction Act of 2005, the Centers for Medicare & Medicaid Services (CMS) initially identified eight preventable adverse events on August 1, 2007, with nine more conditions proposed on April 14, 2008.  They have introduced a plan to help contain …Read More

Preparing For The New Medicare Reimbursement Guidelines: Part II: Documentation Of Altered Skin Integrity In The Hospital

This article was published in Clinical Geriatrics 16:7, p 17-20. 2008. Medicare recently released new reimbursement guidelines that will deny payment for “preventable” complications that arise during hospitalization.  These include such entities as catheter-related infections, fall-related injuries, transfusion with incompatible blood products, and pressure ulcers.  This is Part II of a two-part series on pressure ulcers and Medicare reimbursement. Part I appeared in the June …Read More

Risk Management For Pressure Ulcers: When The Family Shows Up With A Camera

This article was published in Journal of the American Medical Directors Association 2008; 9(5), pp 360-363. Pressure ulcers, although sometimes unavoidable, are frequently viewed as a failure of the health care system. Private civil lawsuits alleging malpractice or negligence related to pressure ulcers are becoming increasingly common. Because of their graphic nature, a photograph of a wound may add value to a plaintiff’s case whether or …Read More

Pressure Ulcers In The Long-Term Care Setting: Clinical Practice Guideline Published By AMDA

Dr. Levine was on the advisory panel for revision of this guideline.This updated guideline is evidence based and incorporates the revised federal guidance to surveyors on pressure ulcers (Tag F314) including risk factors, infection, pain management, treatments based on the wound characteristics, and the resident’s rights to refuse one or more aspects of pressure ulcer care. The guideline also includes the updates for staging according …Read More