Dementia Program Recognized by Centers for Medicare & Medicaid Services; Outpatient Geriatrics, Orthopaedics Bone Health Coaching Programs Receive ‘Age-Friendly’ Designation

Cedars-Sinai programs serving older patients and people with dementia have earned esteemed national distinctions reserved for healthcare models that prioritize improved health and wellness among older adults—a rapidly growing segment of the U.S. population expected to nearly double in the coming decades.

The Centers for Medicare & Medicaid Services (CMS) recently selected the Cedars-Sinai CARES (Care Management/Alzheimer’s Expertise/Resources/Education/Social Support) Program for dementia patients and their caregivers as a Guiding an Improved Dementia Experience (GUIDE) Model site. The Cedars-Sinai CARES Program is among 14 established programs in California, and it is one of only two in Los Angeles selected by CMS for the established program track. 

Additionally, the medical center’s comprehensive outpatient Geriatrics Program for people 65 and older, along with its Bone Health Coaching Program, recently received Age-Friendly Health System Committed to Care Excellence recognition from The John A. Hartford Foundation and the Institute for Healthcare Improvement, in partnership with the American Hospital Association and the Catholic Health Association of the United States. Cedars-Sinai also is among just 30 hospitals nationwide recently selected to join the new Age-Friendly System-Wide Spread Collaborative, which aims to accelerate adoption of evidence-based, high-quality care for older adults across all the medical center’s sites and care settings.

“Cedars-Sinai cares for more patients over 80 than any other academic medical center in the country, so operating under an age-friendly healthcare model is critical to our continued ability to serve our growing community of older adults,” said Bryan Croft, the hospital’s executive vice president and chief operating officer. “In just over a decade, the U.S. will have more people over age 65 than children, for the first time in history. An aging population has unique care needs, and these recognitions further demonstrate that Cedars-Sinai is the premier institution to provide this level of outstanding care.”

Cedars-Sinai Medical Center first received the Age-Friendly Health System Committed to Care Excellence designation in 2020.

Age-Friendly Health Systems integrate the “4Ms” of care: what matters most to each patient, medication safety, mobility and mentation, or mental functioning.

“Integrating the ‘4Ms’ framework into models of care for older people is about providing optimal care and measures of safety while addressing what’s most important to each individual patient,” said Sonja Rosen, MD, chief of Geriatric Medicine. “You can’t assume that everyone’s goals and preferences are the same. At Cedars-Sinai, we strive to help people live as healthy and high-functioning as possible for as long as possible and at the same time, achieve their goals.”

Cedars-Sinai’s outpatient Geriatrics Program has geriatricians who treat patients throughout the community for geriatric syndromes and primary care needs. This includes conducting consultations for falls, osteoporosis, polypharmacy—which is taking five or more medications—dementia, social isolation, loneliness, and other topics of importance for many older adults.

The hospital’s outpatient Bone Health Coaching Program, part of the Geriatric Fracture Program in the Department of Orthopaedics, provides bone health assessments and counsels patients on how to reduce the risk of fragility fractures, often caused by poor bone quality associated with older age, reduced mobility and some medications. Poor bone quality is often a surprise to older adults – unless they are screened, they may not be aware. According to the U.S. Centers for Disease Contorl and Prevention, falls that cause fragility fractures are a primary cause of injury in people 65 and older and often lead to hospitalization, loss of independence and even death. 

“We aim to help preserve good quality of life and independence for our patients," said nurse practitioner Kathleen Breda, MSN, associate director of orthopaedic Clinical Programs. “We’re proud that our Bone Health Coaching Program has connected more than four times the national average of patients with bone health care and is an important element of our age-friendly model of care." 

The CARES Program at Cedars-Sinai provides comprehensive dementia care management for patients with Alzheimer’s disease and other dementias as well as support and training for their family caregivers.

With the CMS selection of the CARES Program as a GUIDE Model site, eligible Medicare patients in the program can access $2,500 annually for adult day care, in-home care and facility care expenses when they need additional help—for example, after a hospital stay or during times of decreased caregiver availability.

Patients in the moderate to late stages of dementia also will receive a CARES Program home visit to help evaluate their needs, ensure safety and promote sustainability of in-home care. Educational offerings for caregivers are also provided.

“The selection of our CARES Program as one of the CMS GUIDE established care sites is a testament to the high quality of care that we provide to patients with memory impairments and the support we provide to family caregivers of dementia patients,” said Zaldy Tan, MD, MPH, director of the CARES Program and the Jona Goldrich Center for Alzheimer’s and Memory Disorders. “We continue to see improved health outcomes in vulnerable patients who are enrolled in the program, and as a GUIDE Model site, we expect this to be further enhanced.”

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