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1. Transitional Care Unit
April 19, 2006
Barbara Goldman, R.N., J.D.
Director, LTC Licensing and Certification
NJDHSS
PO Box 367
Trenton, New Jersey 08625-0367
Dear Ms Goldman,
I am writing you to let you know how valuable Consultant Pharmacists are in the care of our Senior
Citizens. I have worked closely with our Consultant Pharmacist for the TCU the past 8 years since we
opened in 1998. He has been instrumental in making recommendations and educating the physicians in
specific dosing guidelines, renal dosing protocol implementation and avoidance of high-risk medications in
the elderly. His recommendations are valued and although not always followed, at least result in discussion
or consideration of alternate drugs. Last year the leader of the Pharmacy and Therapeutics Committee
requested our Consultant Pharmacist, Frank Breve, to join as a member. Frank’s report focuses on the
TCU but is also global because he has the opportunity to discuss medications that contribute to patient falls
and medications that appear on the Beer’s List that should be avoided.
The proposed Assisted Living Regulations that were recently published in the New Jersey Register under
N.J.A.C. 8:36 do not separate the provider pharmacist from the consultant pharmacist. Although probably
an oversight, I’m writing you to support the proactive decision to amend this regulation. The focus is
different. Provider Pharmacy’s are most concerned with drug allergies or drug-drug incompatibilities but
are not generally patient specific.
Personally, I asked our Consultant Pharmacist for assistance with my mother. She is a community dwelling
widow who lives in a condominium about 5 miles from my home. Her attending physician, a geriatrician
and a renal specialist were seeing her on a regular basis. My mother who is 82 still drives and is
independent in all ADL’s. However, she was turning into a Failure to Thrive person. She couldn’t or
wouldn’t eat; she suffered from dizziness and was having trembling spells. Her physicians told me to
expect it – she is 82. I contacted Frank Breve and gave him the list of 22 medications that my mother was
taking. I gave him her personal history, with my Mom’s consent and asked if he could help. Frank
recommended discontinuing six of the medications, reducing another three and changing the dosing
schedule for two. I gave the Attending Physician the recommendations. He agreed to give it a try. Within
48 hours there was some improvement seen and now 6 weeks later, my Mom is driving and enjoying life
again. Frank saved my mother’s life.
I was my Mother’s advocate. I see the Consultant Pharmacist as our resident’s advocate when it comes to
medication administration. They have access to the big picture, not just the drug profile. I would be happy
to speak with you regarding this issue at your convenience.
Sincerely,
Karen Rodemer, RN, BSN, MS, LNHA
Administrator, Transitional Care Unit
rodemerk@umhospital.org
(856) 853-2114

2. 509 N. Broad Street, Woodbury, New Jersey 08096