The two-campus Division of Geriatric Medicine offers a multi-faceted program led by 16 physicians and 14 nurse practitioners who work together with an extensive interprofessional staff of clinicians and administrators to create a comprehensive program of education, research, administration and clinical care. Ten of the faculty leaders have worked at VCU for 10 years or more, and there is a wealth of experience and sustained excellence of performance. We are growing rapidly, having added 5 faculty members and 3 new programs in the past thee years. The interprofessional nature of our program is reflected in close collaboration and leadership initiatives with 5 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 VCU Medical Center campus has 7 clinical sections: ambulatory care, house calls, transitional care, long term care, inpatient consults, PACE, and palliative care. These 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 5 geriatric fellowship positions, all Orthopedic residents, and a variety of other learners including nurse practitioner, social work, and pharmacy students.
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 both campuses so that the fellows have a broad base of experience when they graduate, and is effectively led by Angela Gentili and re-accredited for 5 years in 2012. Eight of our faculty members are graduates from our fellowship.
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; and full accreditation of our House Calls program from the Joint Commission in 2012 with a perfect score. VCU House Calls 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. The Next Steps grant from the Reynolds Foundation is launching a unique new program of education that will involve more than 500 students from Medicine, Nursing, Pharmacy and Social Work in August 2012. In addition, the VCU program faculty and staff have led the growth and development of the 21-hour Virginia Geriatrics Society conference which attained its highest participation yet with 350 participants and 35 exhibitors in April 2012.
VCU Medical Center
- Arline Bohannon, MD — Vice Chair
- Peter Boling, MD — Division Chair
- Rashmi Chandekar, MD
- Brittany Craven, MD
- Adedayo Fashoyin, MD
- Saima Habib, MD
- Sarah Hobgood, MD
- Pamela Parsons, MSN, PhD
- Rachel Selby-Penczak, MD
Center for Advanced Health Management
Hunter Homes McGuire Medical Center Campus (VAMC)
- Hana Ayele, MD
- Julie Beales, MD
- Katherine L. Coffey-Vega, MD
- Angela Gentili, MD
- Trishana Glover, MD
- Michael Godschalk, MD
- Catherine Kelso, M.D.
Advanced Care Practitioners
- Marie Gerardo, NP
- Beth Hungate, NP
- Coleen Kenny, NP
- Tamera Krukiel, NP
- Susanna Payne, NP
- Martha Purvis, NP
- Cindy Rollins, NP
- Lana Sargent, NP
- Ruth Wiese, NP
The Division of Geriatric Medicine provides these comprehensive services through the VCU Medical Campus. Services offered through the McGuire VA Medical Center are also outlined below.
Ambulatory Care Center
The outpatient geriatric clinic operates Monday through Friday in the Ambulatory Care Center, second floor) at 11th and Clay Street in downtown Richmond. It is a team effort started in 1999 with three faculty members (Boling, Habib, Hobgood) now working in collaboration with four nurse practitioners (Parsons, Purvis, Sargent, and one under recruitment). Clinicians provide geriatric consultation, as well as primary care services and coordination of care. Providers from the clinical team are on-site every day of the week. 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 Virginia Coordinated Care Complex Care Clinic, operating in ACC-2 and a new geriatric medicine outpatient teaching clinic, operated in conjunction with the internal medicine residency program.
Ambulatory Care Center Contact number: (804) 828-9357
VCU House Calls is the oldest of our clinical programs, originating in 1984. The base of operations is in North Hospital downtown. 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 team meeting on Tuesday from 8:30 to 10 during which the team discusses difficult cases. The House Calls program is best considered a doctor’s office on wheels for people that are too sick to come to clinic. Criteria for enrollment include 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 House Calls program has been accredited by the Joint Commission since 1997 and is proud of having a perfect survey in 2012. The clinical team in House Calls includes physicians Linda Abbey, Peter Boling, and Rachel Selby Penczak; nurse practitioners Tammy Krukiel, Ruth Wiese, Beth Hungate and Susanna Payne; and social worker and geriatric care manager Gale Davis. VCU House Calls is proud to have helped create and now to be participating in the federal Independence at Home demonstration program.
House Calls Contact Number: (804) 828-4624
VCUHS Transitional Care, established in 2000, is modeled after Mary Naylor’s program in Philadelphia and involves nurse practitioners that see patients in the VCU Medical Center and then manage their care for several weeks, making home visits and coordinating care, until patients are able to return to their usual clinic providers, or are determined to require permanent enrollment in House Calls. Enrollment is made on specific referral of high-risk patients from medical center inpatient staff using on-line triggers and pathways. Clinical staff members include Beth Hungate, Susanna Payne, and Marie Gerardo.
Transitional Care Contact Number: (804) 828-4624
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 every weekday, for older patients needing pre-operative, peri-operative and post-operative geriatric care, as well as patients who course of inpatient care or post-hospital care planning has become particularly complicated. There 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. Consults are usually requested on-line or by pager. 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 Home Program (Long Term Care)
As part of the continuum of geriatric care, the VCU Division of Geriatric Medicine provides care to patients in several Richmond area nursing homes, in a program that started in 1996. These homes include Lexington Court, Beth Sholom, Laurels of University Park, Westport, Manor Care Stratford Hall, Envoy of Stratford Hills, Lucy Corr, Sitter and Barfoot, and Henrico Health Care. On occasion we have followed patients at several other facilities including Hanover Health Care, Covenant Woods, Laurels of Willow Creek, Laurels of Bon Air, Manor Care Imperial. There are facilities where we accept patients from outside hospitals (Lucy Corr, Lexington Court, Beth Sholom). 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. The clinical team includes physicians Peter Boling, Arline Bohannon, Nalini Morishetty, and Saima Habib as well as nurse practitioners Coleen Kenny and Cindy Rollins.
Nursing Home Program Contact Number: (804) 828-5306
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
PACE (Program for All Inclusive Care of the Elderly)
In 2009, VCU joined in a contractual partnership with Riverside Health System to provide medical services at two PACE sites now operating in greater Richmond, one on Gordon Avenue (701) which was a capacity of about 155, and one on McTavish Street which has a capacity of 180. PACE is a unique program primarily for low income older individuals who are clinically eligible for nursing home care and covered by Medicare and Medicaid. There is a wonderful comprehensive adult day health center that provides a rich menu of services on weekdays. PACE also provides transportation and coordinates and pays for all other aspects of enrolled beneficiaries’ health care. Geriatricians at the PACE sites are Rashmi Chandekar (McTavish) and Sarita Golikeri (Gordon Avenue).
The Division provides a variety of contractual services designed to enhance quality of care. These currently include nursing home medical director positions at Beth Sholom (Morishetty) and Lucy Corr (Bohannon), as well as Horizons Hospice (Selby-Penczak, Hobgood). 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 director of long term care for the health system and as a geriatrician consultant to Virginia Premier Health plan.
Coverage of the geriatric clinical service is provided 24-7-365 by a faculty member, available at (804) 828-5306.
McGuire VAMC Clinical Services
- The VAMC staff members of the Division provide services at the following locations:
- Geriatric Health Care Center (outpatient clinic)
- Nursing Home Care Unit
- Inpatient Hospice Unit
- Home-based primary care
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.
Division of Geriatric Medicine
West Hospital, 2nd Floor
Richmond, VA 23298
Phone: (804) 828-9357
Peter Boling, MD
Richmond, Virginia 23298
Richmond, Virginia 23298-0102
Phone: (804) 828-5323
Fax: (804) 828-8660