Nursing home group offers fixes for 'flawed' painkiller legislation

David Gifford, M.D., is excited to get back to his roots. After nearly six years as director of the Rhode Island Department of Health — an experience he describes as both rewarding and frustrating — the geriatrician returned to long-term care in May as the senior vice president of quality and regulatory affairs for the American Health Care Association.

Some might say “Giff,” as he is known to friends, was destined for this role. The son of a physician and a Yale librarian, he grew up hearing dinner table conversations about the intersection of policy, process and quality. Gifford also was close to his grandparents, which gave him an appreciation for seniors.

Gifford’s interest in geriatrics was sparked during his first year of medical school at Case Western Reserve University, when students were paired with a long-term care resident. Later, at UCLA, he had the opportunity to learn from the influential geriatrician David Reuben. Gifford also did a one-year fellowship with quality guru Joe Ouslander.

When Gifford took his first position at Brown University, he was eager to practice as a nursing home medical director. “It was incredibly rewarding not only to get to know the patients and families, but also to work in teams and be able to influence policies and practices,” he says.

Gifford continued to focus on quality improvement as his career progressed. As chief medical director for Quality Partners of Rhode Island, he directed the Centers for Medicare & Medicaid Services’ National Nursing Home Quality Initiative. 

During his time as Rhode Island’s health chief, Gifford gained acclaim for high vaccination rates during the H1N1 pandemic. He also helped revamp state surveys to focus more on care.

Unfortunately, as the country slipped into recession, Rhode Island was hit hard. Gifford lost 20% of his budget and half of his surveyors.

“The budget cutting wore me down,” he says, explaining his decision to resign a year into his second term. “There was going to be another two to three years of cuts, so we wouldn’t be able to focus on anything innovative.”

“Always interested in helping people do a better job” is how Virginia Burke, president of AHCA/NCAL’s Rhode Island affiliate, describes Gifford. “He’s all about the data and acting on evidence — and he doesn’t have much patience for people who don’t strive for quality improvement.”

Colleagues describe Gifford as steady, intelligent and committed. “He knows what he wants and what needs to happen to get there,” says Vince Mor, the former chair of Brown’s Department of Community Health. “But he is a friendly guy who cares about people — especially older people.”

If Gifford is driven in his work, he is passionate about the rest of life, too. The 48-year-old soccer enthusiast plays in a recreational league and enjoys rooting for FC Barcelona, one of Spain’s top leagues. He also cheers on his son, William, at high school games with his wife Deidre, an Ob-Gyn.

They, in turn, will be among the crowd eagerly watching to see how his fancy footwork helps team AHCA/NCAL.

Resume

1989
Awarded doctorate of medicine from Case Western Reserve School of Medicine

1994
Earns master’s in public health in epidemiology from UCLA

2000
Named one of Rhode Island’s top five geriatricians by RI Monthly magazine

2002
Directs rollout of CMS National Nursing Home Quality Initiative measures

2004
Becomes associate professor of medicine and community health at Brown University

2005
Appointed director of Rhode Island’s Department of Health

2010
Presented with Distinguished Service Award by National Governors Association

2011
Named AHCA/NCAL’s senior vice president of quality and regulatory affairs