Available Services:
Available Services:
- Innovative Independent Living In-House Medical Services
- Assisted Living In-House Medical Services
- Skilled Rehab & Long Term Care Medical Services
- Outpatient Geriatric Consultation Clinic
Quality Geriatric Care
Not just warm bodies
Quality Geriatric Care
Not just warm bodies
Our elderly deserve nothing less!
Innovative Independent Living Services
On-Site Geriatric Primary Care
Innovative Independent Living Services
On-Site Geriatric Primary Care
- Medical visits by nurse practitioners (NPs) in the comfort of your apartment at no extra cost.
- Regular wellness visits every two to three months to stay a step ahead of medical problems and case manage emerging needs.
- Additional acute visits to address issues and medical concerns as they arise
- No office appointments necessary; simply request a visit at the facility, or call our office. You will be seen within a week by one of our NPs at your apartment.
- Our providers will order home-health services as needed and manage complex issues.
- On-site X-Ray or EKG is available through Mobile-X , except in case of an emergency where immediate evaluation is needed.
- Our billing is no different than regular primary care offices. We copy your insurance cards and bill your insurance. You are only responsible for your standard co-pays if you have no secondary insurance.
- We accept all insurances, and we always apply to join new plan networks in our service area.
Turning Independent Living into
Independent Living PLUS
Turning Independent Living into
Independent Living PLUS
- Independent livings are a popular choice for our elderly, but they find that the medical care in such facilities is limited or totally lacking.
- Our services in this settings are designed to bring independent living closer to assisted living standard and turn the independent living to an independent living PLUS.
- There are no nurses or ancillary services in independent living, so in the process of our geriatric work we will utilize outside resources as they become necessary. That includes medication management, temporary home health services, temporary case management, PT/OT therapies, and portable EKG and X-rays, etc.
- Sometimes all a resident needs is a simple intervention, like medication management, to stay in the cheaper setting of independent living. We can not expect some mild dementia patients to remember complex changes and new medications. Every change in treatment can become a potential medication error which can cause complications like a life altering fall, hospitalization, or even nursing home placement. Our team is trained to foresee such issues and take measures to prevent them whenever possible.
- Our Nurse Practitioners train directly under Dr. Fazeli and are experienced in managing high complexity geriatric patients in independent living. With our NPs' strong clinical capabilities and Dr. Fazeli's availability to them via Tele-Medicine, we are able to offer cutting edge on-site geriatric service at select independent living facilities.
- This rare geriatric service allows "Aging in Place" for most independent living residents, and no one is paying extra for it. The practice bills the insurance in the customary manner, just like any medical office, and there is no surcharge for the On-Site service.
- Aside from benefits to residents, the facilities themselves would eliminate the need for transportation to doctors offices and would benefit from the added case management that geriatric providers do as a matter of routine in their clinical work.
- Less ER visits and hospitalizations
- Built-in palliative care expertise
- Residents stay at Independent Living longer instead of transitioning to Assisted Living due to unmet needs
Frequently Asked Questions in Independent Living
Frequently Asked Questions in Independent Living
• Do I still need to go to my community provider for primary care?
NO, Maine Geriatrics team will handle all your primary care needs with the added bonus of geriatric expertise.
• Do I get to keep my specialists?
YES, and we will request notes and recommendations from the various specialists to ensure that there is no over-medication and conflicting recommendations. You should let us know about all outside consultants to allow us the opportunity to establish contact with them.
• Can I stop seeing outside specialists once in your practice?
This is determined on a case by case basis. If the Maine Geriatrics team feels that the purpose of the visits does not change management or if you decide that it is too inconvenient, then our team will handle all problems in-house.
• How can I transfer medical records to your practice?
Complete the release of information form and our office will take care of the rest.
• How am I going to get my medication refills?
Our providers will call in any new medications and any expired prescriptions. In addition, our office will be receiving notifications from your pharmacy and will handle the refill requests as they arrive.
• Do you handle palliative care or do you refer to hospice?
Our team is very proactive with palliative care if and when palliative care becomes the plan. We use the local hospices, but we remain very involved in the medication management of all patients so that they can benefit from our palliative expertise.
• Will you involve my POA (power of attorney)?
YES, if you wish, or if there are memory concerns then we would involve your power of attorney in your care and will coordinate with her or him.
Assisted Living Services
On-Site Geriatric Primary Care
Assisted Living Services
On-Site Geriatric Primary Care
- Optional Medical Directorship
- Weekly On-Site Visits by Nurse Practitioners to the Facility-We adjust the number weekly visits based on the needs of the facility and the residents.
- 24/7 On-Call Coverage to Support the Assisted Living Nursing staff & pharmacists.
- Reducing unnecessary ER visits and Hospitalizations
- Allowing true Aging in Place for residents, even for those who suffer physical or dementia decline
- Delay or Prevent Nursing Home Placement
Why Geriatrics in Assisted Living makes a difference
Why Geriatrics in Assisted Living makes a difference
- Most, if not all, assisted livings are based on a social model, but residents are older and more complex on arrival compared to a few decades ago. There is a pressing need for an active medical presence and involvement to supplement the social model and to keep these residents safe as they age in place. When this medical presence happens to be geriatrics and only geriatrics, the benefit to the residents can be life changing.
- Our geriatric providers feel comfortable handling complex cases and a multitude of geriatric problems, including dementia related issues, multiple chronic conditions, polypharmacy, wound prevention and treatment, fall assessment and treatment, and many other geriatric syndromes and conditions.
- While we are aggressive in managing medical problems to prevent decline, we also understand that there comes a time for some of our patients when they need us to switch focus to palliative care and comfort. In such cases, we proactively shift focus and become equally aggressive in pursuing the goals of comfort and quality of life with tailor made plan to meet individual needs and conditions.
- In some palliative cases, we can add hospice service for companionship, social worker/counseling, personal care attendants, or equipment needs. Our team’s expertise extends to management of comfort medications without the need to delegate this important component of hospice care.
Nursing Home and Skilled Rehab Services
Nursing Home and Skilled Rehab Services
- Experienced Geriatrician Medical Directorship
- Weekly On-Site Visits by Nurse Practitioners to the Facility-We adjust the number of days per week based on the needs of the facility and residents
- On-Site Wound Care rounds and bedside staff education
- Dementia Care Services
- Expert Palliative Care/Hospice Geriatric Management
- Involvement and Support to all Quality Improvement Initiatives and providing ongoing geriatric input
- Assistance with Case Management and safe discharge of Short-Stay Skilled Rehabilitation patients
We believe that geriatric physician leadership is a vital necessity to improving geriatric care in nursing home facilities, and Dr. Fazeli has always been an active member of the leadership teams of facilities he served over the years.
Quality Improvement in Long Term Care and Skilled Rehab
Quality Improvement in Long Term Care and Skilled Rehab
Aside from quality care, we are also very active in case management of short stay patients who come to the facility for short term rehab. We strive to make sure they return to a safe environment at home and if that's not feasible, our providers actively work with families in determining the right time for difficult choices like moving to a higher level of care.
We are proud of the fact that our CMS quality measures in past and present affiliate facilities ranks at the top 10 percentile. One example is the quality measure of use of antipsychotics in nursing home dementia patients.
While the national average of antipsychotics use in dementia residents is ~17% in 2019 , our affiliated facility, Durgin Pines in Kittery, Maine, hovers between 0-3% at any given time. This makes a tremendous difference in the quality of life of dementia residents and shows true culture of caring without over-medicating. The vast majority of dementia patients are NOT psychotic-they are simply confused, and adding anything that makes confusion worse is of no help.
We help facilities, like Durgin Pines, change the caregivers understanding and approach to dementia care and many other important issues that matter to the quality of life of nursing home residents.
We appreciate the front-line work of nurses and CNAs who share our commitment to limit the use of psychoactive medications in the daily care of dementia patients.
What Does Geriatric Medicine Offer Beyond General Medicine?
What Does Geriatric Medicine Offer Beyond General Medicine?
- Comprehensive care of the elderly with providers more involved in the case management of multiple medical and social issues
- Assessment and treatment of memory loss and confusion
- Assessment and treatment of depression
- Assessment of polypharmacy and potential impact of discontinuing drugs used for chronic conditions
- Management of non-surgical wounds and pressure sores is a rare competency in our geriatric practice
Assessment of environmental needs and placement issues
Maintaining a holistic view and keeping the prognosis in mind when following outside consultant recommendations
- Assessment and management of difficult behavior in dementia or stroke patients
- Management of multiple or uncontrolled chronic conditions in the elderly
- Comprehensive palliative and end-of-life care without the need to delegate the medication management component to hospice
- Assessment and management of frequent falls in the elderly
- Assessment and management of incontinence
- Management of chronic pain in the elderly
- Competency assessment and addressing different service needs
Outpatient Geriatric Consultation Clinic
Outpatient Geriatric Consultation Clinic
Our practice is primarily facility-based, but we remain committed to our community elderly who need a geriatric consultation to help them stay at home or want to know if its time to move out of their home- which is one of life's hardest decisions.
Our clinic is not part of our business model, but we consider it an important service given the limited access to experienced and trained Geriatricians.
Common reasons we see patients in the clinic include: memory issues, dementia behaviors, depression, falls, polypharmacy (too many medications), driving ability issues, frailty, incontinence, behavioral problems, guardianship and competency , among others Geriatric issues.
All clinic patients must be 65 years or older with case by case exception for younger adults with disabilities. To schedule a clinic appointment please call us.
Please feel free to contact us with any questions
Office #: 207-780-6565 or Email us
Office Address: 22 West Cole Road, Biddeford, ME 04005