The forgotten population: A growing need for geriatricians
As fewer physicians choose to specialize in geriatric medicine, experts at VCU strive to meet the health needs of an increasing population of older adults.
Geriatric Medicine
The three-campus Division of Geriatric Medicine offers a multi-faceted program led by twelve physicians and 20 nurse practitioners who work together with an extensive inter-professional staff of clinicians and administrators to create a comprehensive program of education, research, administration and clinical care. We are growing rapidly, having added five faculty members and three new programs in the past three years. The inter-professional nature of our program is reflected in close collaboration and leadership initiatives with five well-known VCU schools including Medicine, Nursing, Social Work, Pharmacy, and Allied Health (Physical and Occupational Therapy as well as Health Administration). We have a truly team-based approach to education, research and clinical care.
The first campus at The VCU Medical Center has three clinical sections: ambulatory care, inpatient consults, and palliative care.
The second campus at the VCU Center for Advanced Health Management has three clinical sections: ambulatory care, home-based primary care (HBPC), and the nursing facility attending service.
At our third campus at the Hunter Holmes McGuire Veterans Affairs Medical Center, geriatricians work and teach in the Geriatric Health Care Center which is an outpatient clinic, the on-site nursing home-care unit, the inpatient palliative care unit, and the home-based primary care program. The VA medical center serves as the home base for the geriatric fellowship, which involves all three campuses so that the fellows have a broad base of experience when they graduate, and is effectively led by Dr. Sarah Hobgood and re-accredited for five years in 2017. Eight of our faculty members are graduates from our fellowship.
These three venues support educational programs for more than 500 learners each year, including all 400 M1 and M2 students, all 90 internal medicine residents, all of the five geriatric fellowship positions, all Orthopedic residents, and a variety of other learners including nurse practitioner, social work, and pharmacy students.
The Division is proud of several successful initiatives including: two Reynolds grants (2001 and 2010); a Geriatric Education Center (2010) which is a statewide collaboration directed by Ed Ansello in the Center on Aging and co-directed by Peter Boling. The VCU Home-based Primary Care Program was also approved July 31, 2012 for participation in the national Independence at Home demonstration program working in collaboration with Medstar Washington Hospital Center and the University of Pennsylvania as the Mid-Atlantic Independence at Home Consortium. Leaders of the Consortium were directly responsible for creating the demonstration through the legislative and regulatory process. In addition, the VCU program faculty and staff have led the growth and development of the Virginia Geriatrics Society conference for the last 20+ years, which enjoys broad participation from doctors, advanced practice providers, social workers, and pharmacists.
About the Chief
Faculty
Division of Geriatric Medicine
VCU Medical Center
- Arline Bohannon, MD - Vice Chief
- Sarah Hobgood, MD - Assistant Dean, Medical Education
- Rachel Selby-Penczak, MD - Medical Director, End of Life Resource
Center for Advanced Health Management
- Ashu Acharya, MD
- Carl J. Bergman, MD - Medical Director Nursing Facility Attending Service
- Peter Boling, MD — Division Chief and Medical Director, Senior Services & Post Acute Care
- Brittany Craven, MD - Medical Director, Geriatric Ambulatory Clinics
- Kristina Fernandez, MD - Associate Director, Geriatric Education
- Saima Habib, MD
- Nasiffa Hossain, MD
- Ather Iqbal, MD
- Abe Menon, MBBS
- Lovelina Patel, MD
- Kathryn Rackson, MD - Medical Director, Home Based Primary Care
- Kathryn Sellman, MD
- Julia Siegel-Breton, MD - Medical Director, Remote Patient Monitoring & Hospital at Home
- Weera Sukhumthammarat, MD, DDS
- Michael Weissberger, MD - Infomatacist
Advanced Care Practitioners
- Morgan Childress, NP
- Shirley Constantino, NP
- Margaret Copland, NP
- Atalie Doyle, NP
- Robyn E, Feely, MSN, GNP-BC
- Jessica Gallon, NP
- Marie Gerardo, NP
- Lyons Hardy, NP
- Carman Henderson, NP
- Beth Hungate, NP
- Lisa Johnson, NP
- Tamera Krukiel, NP
- Sara Majewski FNP-C, RN
- Amanda Meadows, NP
- Kristen Meikeljohn, NP
- Cassaundra Minter, FNP
- Pamela Parsons, NP
- Martha Purvis, NP
- Mimi Flemmer, NP
- Arlene Rollins, NP
- Lana Sargent, NP
- Meagan Sutton, NP
- Leigh West, PA
Social Work & Geriatric Care Management
- Ashley Mickle, LCSW
- Charlene Smith, MSW
- Megan Stucke, LCSW
- April Wilson, LCSW
- Annette Young, LCSW
Clinical Areas
Learn more about our clinical services.
The Division of Geriatrics provides these comprehensive services through the VCU Medical Campus (VCUMC) and the Center for Advanced Health Management (CAHM):
Ambulatory Care Center - VCUMC and CAHM
The division currently operates three ambulatory clinics: a small geriatric clinic in the Ambulatory Care Center (3 days/week), a larger geriatric clinic at CAHM (5 days/week) and a Complex Care Clinic at CAHM (5 days/week) which treats any adult patients 18 years or older who have complex medical needs. Clinicians provide geriatric consultation, as well as primary care services and coordination of care. Patients that require other services in the geriatric continuum of care are seen at home, in nursing homes, or in the hospital and will be referred within the Geriatrics program to other team members on request and as needed.
In addition, Arline Bohannon is medical director for the VCU Complex Care Clinic (separate clinic from CAHM), operating in ACC-2 and a new geriatric medicine outpatient teaching clinic, operated in conjunction with the internal medicine residency program.
MCV Ambulatory Care Center contact number: (804) 828-9357
CAHM Ambulatory contact number: (804) 254-3500
Home-Based Primary Care (HBPC) - CAHM
VCU HBPC is the oldest of our clinical programs, originating in 1984. The base of operations is at the Center for Advanced Health Management, on Laburnum Ave in Richmond, VA. Clinical staff members make home visits every weekday during daylight hours to provide both ongoing primary care as well as urgent care for the patients. There is a weekly interdisciplinary team meeting on Tuesdays during which the team discusses difficult cases. The HBPC program is best considered a doctor’s office on wheels for people that are too sick to come to clinic. Criteria for enrollment include VCU patients accepting our providers for primary care, living within 15 miles from the hospital, being unable to leave home to be seen in clinic without great effort, being adult (no pediatrics currently), and having capacity in the program which is limited by the number of providers. The clinical team in HBPC includes physicians, nurse practitioners, nurses and social workers. VCU HBPC is proud to have helped create and now to be participating in the federal Independence at Home demonstration program, proving the merits of home-based primary care.
House Calls Contact Number: (804) 354-8108
Transitional Remote Patient Monitoring (tRPM)
VCU Health Transitional Remote Patient Monitoring (tRPM) provides ongoing remote care for up to 30 days post-discharge via an electronic platform. This includes monitoring of vital signs and clinical signs and symptoms. Monitoring capability includes blood pressure, heart rate, pulse ox, temperature, weight, and blood sugars. Patients go home with a tablet and Bluetooth enabled peripherals to reliably check their own vitals. Out of range vital signs are then sent to a nursing team who receives an alert via page from the platform. There is also a care coordinator on staff to assist with complex case management needs such as setting patients up with medical equipment, home health services, transportation, and financial screenings/support. Enrollment is made on specific referral of high-risk patients from medical center inpatient staff.
- Transitional RPM supports the physician – being able to transition a patient to return home sooner from the hospital while continuing to monitor their condition
- RPM offers the patient added comfort – of having a care team still monitoring them once they return home
- 24/7 access to a RN allows for care or interventions to get to the patient sooner, and avoid unnecessary utilization
With access to nurses 24/7, patients can be connected to care sooner. Ultimately decreasing hospital readmissions and improving quality of care. The tRPM program includes a transitional telemedicine clinic where select patients are scheduled for post-hospital telemedicine appointments with our Continuum Integration Center’s physician/advanced practice provider team with the goal to support a successful transition back to their usual source of care. While enrolled in remote monitoring, a nurse checks on the patient at least every 72 hours via phone call. If a patient’s condition warrants, the transitional telemedicine clinic physician or advanced practice provider is consulted and care is rendered to meet the patient’s needs.
Transitional Remote Patient Monitoring Contact Number: (804) 828-1969
Inpatient Geriatric Service Consults - VCUMC
The inpatient geriatric consult service was launched in 2002 and then revamped in 2009 under the expert leadership of Dr. Sarah Hobgood. Geriatric consults are performed 7 days a week, for older patients needing pre-operative, peri-operative and post-operative geriatric care, as well as patients whose course of inpatient care or post-hospital care planning has become particularly complicated. There is a particularly strong relationship with Orthopedics, Trauma and Neurosurgery services, but Geriatric Medicine “covers the house.” The consult service is supported by residents from Internal Medicine and Orthopedic Surgery, as well as by Geriatric fellows. Dr. Hobgood is involved in evaluation of the consult service and performance improvement efforts related to inpatient geriatric care. The consult service works closely with the other clinical components of the Division to provide inpatient support when patients from the group practice require inpatient care.
Inpatient Consults Contact Number: (804) 828-5306
Nursing Facility Attending Service - CAHM
As part of the continuum of geriatric care, the VCU Division of Geriatric & Continuum Services provides care to patients in several Richmond area nursing homes, in a program that started in 1996. Other patients are referred from VCU Medical Center, and in particular many are from our established geriatric care population as part of our commitment to the continuum of care. Nursing home visits for both scheduled and urgent care are made every weekday and sometimes evenings and weekends, at the discretion of the clinical staff.
Nursing Home Program Contact Number: (804) 254-3500
Palliative Care - VCUMC
Since 2009, Dr. Rachel Selby-Penczak has been increasingly involved in Palliative Care, working as an inpatient attending on the Smith Palliative Care service at VCU Medical Center. In 2011 Dr. Selby Penczak helped open the new and successful Horizons hospice office in metro Richmond as the lead medical director, and in 2012 Sarah Hobgood joined Rachel as an associate medical director.
Palliative Care Contact Number: (804) 828-4624
Clinical Administration - CAHM
The Division provides a variety of contractual services designed to enhance quality of care. These currently include nursing home medical director positions at Lucy Corr (Bohannon), and Bon View (Bergman). Peter Boling has served as a medical advisor and medical director in nursing home care settings (7 years), various home health agencies including a role as a member of the Strategic Advisory Board for Amedisys which is the largest private home care agency in the US, and hospices. Boling and Parsons have provided services as federal monitors for distressed nursing homes. Working with Jay Holdren, Peter Boling is an internal advisor to VCU Health System in developing initiatives in the continuum of geriatric care and holds specific roles as Medical Director of Post-Acute Services for the health system and as a geriatrician consultant to Virginia Premier Health plan.
After Hours - All Sites
Coverage of the geriatric clinical service is provided 24-7-365 by a faculty member, available at (804) 254-3500.
Research
Learn more about our cutting edge research.
The Division has several faculty members that are engaged in research. Educational research is being done as a component of our large educational grant programs (Reynolds and VGEC), looking at the impact of several educational models, curricula, and venues on learner knowledge, skills, and attitudes related to aging, as well as function on inter-professional teams.
Below are descriptions of ongoing research in Geriatrics:
- Divisional faculty members are looking at tiered population health management in a younger population with a subset that has advanced chronic illness in the Virginia Coordinated Care program. Working with Dr. Wally Smith, Dr. Boling co-wrote a $1.2 million, two-year grant funded by AHRQ for this evaluation which involves Dr. Arline Bohannon who is medical director for that program. Dr. Bohannon has a longstanding interest in health disparities and quality of care for minority populations.
- The impact of the geriatric medicine consultation service is under evaluation by Dr. Sarah Hobgood who has worked with two AFAR student grantees on this initiative and has presented several abstracts, including promising initial data related to the geriatric trauma patient population.
- VCU Transitional Care, with data gathered since 2000, has generated abstracts regarding cost savings and improved quality. These data along with data from the House Calls program that has operated for 25 years helped to anchor the Independence at Home (IAH) Act, and the subsequent approval of the mid-Atlantic Independence at Home consortium as one of the demonstration sites. Overall evaluation of the IAH demonstration is under CMS contract to an outside vendor.
- Pam Parsons, MSN, PhD has internal funding to examine the impact of inter-professional service learning venues on clinical care outcomes and learner skills and behaviors, working with Pharmacy and Social Work. She has also developed pilot data on biopsychosocial causes of the symptom of fatigue in elders that live in low income housing, and has published on coordination of care and use of ambulance care for emergency services in this publication. She has recently completed work on a contract from HUD to look at unmet needs and service use by elders in low income housing which is an area of particular interest for her.
- Dr. Michael Godschalk has study male health problems with a particular focus on urinary incontinence, as well as male sex hormone changes with age.
- Dr. Angela Gentili is engaged in a VA study of personalized care for older adults with low back pain working with Deborah Weiner at the University of Pittsburgh.
Along with medical education, the Division is interested in health services research related to a number of topics in the realm of improved chronic illness care, as well as clinical research on specific conditions and therapies, and research on aging itself.
Contacts
Division of Geriatric Medicine
Division of Geriatric Medicine
West Hospital, 10th Floor
Box 980055
Richmond, VA 23298
Phone: (804) 628-9942
Division Contacts
Medicine
Peter Boling, MD
Division Chief
Box: 980055
Richmond, Virginia 23298
E-mail: peter.boling@vcuhealth.org
Administration
Wendy Walker
Division Administrator
Box 980055
Richmond, Virginia 23298-0102
Phone: (804) 628-9942
Fax: (804) 628-3095
Email: wendy.walker@vcuhealth.org
Jay Holdren
Director of Senior Services & Continuum Integration, VCU Health
Box 980218
Richmond, Virginia 23298
Phone: (804) 348-0159
Email: jay.holdren@vcuhealth.org
Betty DeWeese
Practice Operations Manager, CAHM Home-Based Primary Care
Box 980218
Richmond, Virginia 23298
Phone: (804) 354-8108
Email: betty.deweese@vcuhealth.org