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    Consider nursing home optometry as practice option

    Increasing elderly population and disease incidence means more need for care


    Know the players

    The key to success in a nursing home setting is having administrative support from the outset. Important players include facility administrator, director of nursing, director of social services, and the medical director or attending physician.

    The facility administrator is in charge of all aspects of the facility and who will make the decision to sign a contract with the OD to perform services. He will make sure everyone else in the facility is on board.

    The director of nursing understands each patient’s care plan and who will benefit from optometric services.

    The director of social services is the best person for day-to-day interaction and can be the difference between a great or poor relationship with a facility. She makes sure patients are scheduled, rooms are reserved for exams, and proper paperwork is provided and completed before, during, and after the exam.

    The medical director or attending physician provides the order for care. In many facilities, the OD can examine a resident only with a physician’s order stating there is a need.

    A team effort with each of these members of a nursing home chain of command is vital. Nurturing these relationships will go a long way toward continued success.

    Related: 6 steps to open a practice



    Providing optometric care in this setting requires mobile equipment, but most ODs graduate from optometry school owning almost everything that they will need.

    See Table 1 for a comprehensive list of equipment to get started.

    Figures 5 and 6 illustrate what I carry in my bags.


    From experience, I have learned that the nursing home staff will be very appreciative if the OD can help repair broken and bent glasses. This service does not generate income, but the goodwill for being able to help with small things make a huge difference in earning respect in a nursing home facility.

    Related: 5 zones of your practice that need TLC


    The social worker is the go-to person to have information prepared for the OD before starting the exams for the day.

    Be sure you have three required forms the day of the exam for each patient:

    • Fact sheet, which includes personal information, diagnoses, and insurance information

    • Medication administration record, a section of the resident’s nursing home master chart which includes a full list of diagnoses, medications, dosages, and other medical information

    • Physician’s order, which is necessary for Medicare coding guidelines

    James Hill, OD, FAAO
    Dr. Hill provides nursing home care to multiple facilities in his area and holds a specialty low vision clinic at the Medical University ...


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