SNF THIS

* This episode was recorded live at the PALTmed National Conference in Anaheim 2026Death is one of the most certain parts of life — and yet in healthcare, it's often the hardest conversation to have. In this episode of SNF This, we sit down with Dr. Alfonso Gonzalez for an honest, compassionate, and long-overdue discussion about end-of-life care in the post-acute setting. Dr. Gonzalez walks us through how to approach conversations about death with patients and families — when to have them, how to frame them, and why avoiding them often does more harm than good.He also clears up one of the most misunderstood areas of care: hospice. What it actually is, what it isn't, and why so many patients and families come to it too late — or not at all — because of fear and misinformation.At the heart of this episode is a simple but urgent reminder: medicine is not just a clinical practice. It is a deeply human one. And when we strip away the paperwork, the protocols, and the pressure to treat at all costs, what remains is the responsibility to walk alongside our patients with honesty, dignity, and compassion — all the way to the end.A must-listen for physicians, nurses, administrators, and anyone who has ever sat across from a family that needed someone to just tell them the truth.

In this episode of SNF This, we sit down with Dr. Irene Hamrick, gerontologist and Supervising Physician for VitalCare Connect, for a deep dive into one of the most underdiagnosed culprits in post-acute care: dehydration. Dr. Hamrick breaks down how something as seemingly simple as fluid balance can drive some of the most serious acute presentations in elderly patients — from kidney dysfunction and blood pressure instability to altered mental status. If you're caring for seniors and not thinking about hydration first, this episode will change how you approach the workup.

In this episode of SNF This, Dr. Aaron Anderson, CMO of Gadzoom Health, joins host Chance and Noah to unpack electrolyte management in skilled nursing—beyond chasing lab numbers to true patient stability.Key Takeaways    •    Trends over snapshots: Focus on serial trends (e.g., rising Na+ trajectory) rather than isolated values for safer corrections.     •    Treat the patient, not the number: Prioritize symptoms (confusion, weakness, seizures) and clinical context over rigid targets.    •    Pitfalls: Over-reliance on one-off BMPs leads to yo-yo corrections; integrate with PMH, meds (e.g., diuretics), and readmit risks.Dr. Anderson shares real SNF cases, emphasizing multidisciplinary handoffs and telehealth for timely tweaks. Perfect for DONs, NPs, and MDs tackling post-acute chaos.

Join us In this episode with guest hosts Dr. Aaron Anderson and Noah Dobson PA as, we unpack one of the most common — and often misunderstood — clinical challenges in skilled nursing facilities: urinary tract infection (UTI) management. Our discussion centers on how to distinguish true infections from asymptomatic bacteriuria, why over-testing leads to overtreatment, and how providers can apply better clinical judgment to protect residents and preserve antibiotic effectiveness.We break down key decision points:•    When to test — identifying residents with localized urinary symptoms or systemic signs consistent with infection.•    When not to test — recognizing that cloudy urine, foul odor, or simple confusion don’t automatically indicate a UTI.•    When and how to treat — following antibiotic stewardship principles, ensuring cultures guide therapy, and balancing clinical action with conservative management.Through real-world examples from the geriatric care setting, we explore how interdisciplinary teams — nurses, NPs, physicians, and infection control leads — can collaborate to reduce unnecessary antibiotic use, improve diagnostic accuracy, and enhance care quality in the skilled nursing environment.By the end of this episode, listeners will gain practical frameworks to support more deliberate testing, smarter prescribing, and better resident outcomes — turning a routine diagnosis into an opportunity for clinical excellence.

Join us with guest provider Bruno Silva ARNP as we explore practical strategies for managing behavioral health in SNFs using both pharmacologic and non-pharmacologic approaches, with a strong focus on patient-centered care for residents with dementia and age-related behavioral health needs. The episode offers valuable insights for providers, administrators, DONs, nurses, CNAs, and families, highlighting ways to improve safety, communication, and quality of life for older adults in post-acute and long-term care settings.Additional Resources: Laura N. Gillian, PhD: COPE, a biobehavioral, home-based interventionConstantine Lyketsos, MD: Methodology: Define symptoms clustersArt Walaszek, MD:Book: Behavioral and Psychological Symptoms of DementiaDallas Seitz MD & Jennifer Watt MD:Methodology: Canadian Clinical Practice Guidelines for Assessing and Managing BPSDMagierski & Religa: 2020 review “Pharmacotherapyof Behavioral and Psychological Symptoms of Dementia: State of the Art and Future Progress”Gill Livingston MD: Methodology: START - STrAtegies for RelaTivesNaomi Feil: Methodology: Validation method, The Validation BreakthroughNancy Mace & Peter Rabins: The 36 Hour Day: A family Guide to Caring for People Who Have Alzheimer Disease, Other Dementias, and Memory Loss (Still the boss after 40 years)Jolene Brackey: Creating Moments of Joy Along the Alzheimer’s JourneyJoanne Koenig Coste: Book: Learning to Speak Alzheimer’s: A Groundbreaking Approach for Everyone Dealing with the Disease (Habilitation)Pauline Boss, PhD: Book: Loving Someone Who has Dementia: How to Find Hope While Coping with Stress and Grief 

In this episode we discuss everything you need to know about the skilled nursing industry. Our guests on this episode are Tennille Smith and Emily Durbin, who each have over 20 years of experience in the post acute world.