Key Responsibilities and Required Skills for Geriatric Physician Assistant

🎯 Role Definition

The Geriatric Physician Assistant (PA-C) delivers high-quality, patient-centered medical care to older adults across settings including outpatient geriatric clinics, skilled nursing facilities (SNFs), long-term care, home health, and hospital consult services. The role emphasizes comprehensive geriatric assessment, chronic disease management, polypharmacy reduction, cognitive and functional evaluations, interdisciplinary care coordination, advance care planning, and documentation within the electronic medical record (EMR). Ideal candidates demonstrate clinical autonomy, strong communication with families and care teams, and a commitment to improving outcomes for older adults.

📈 Career Progression

Typical Career Path

Entry Point From:

Family Medicine or Internal Medicine Physician Assistant roles
Primary Care PA with experience in chronic disease management
Hospitalist or Emergency Medicine PA transitioning to geriatric practice

Advancement To:

Senior/Lead Geriatric PA or Clinical Coordinator
Director of Clinical Services for Post-Acute or Long-Term Care
Palliative Care or Hospice Advanced Practice Provider lead
Nurse Practitioner/PA Clinic Medical Director for Geriatrics

Lateral Moves:

Home Health Advanced Practice Provider
Skilled Nursing Facility Medical Director (with additional credentialing)
Transitional Care or Case Management leadership roles

Core Responsibilities

Primary Functions

Conduct comprehensive geriatric assessments including history, medication review, cognitive screening (MMSE, MoCA), functional status (ADLs/IADLs), gait and balance evaluation, and fall risk assessment to develop individualized care plans for older adults.
Manage acute and chronic medical conditions commonly seen in older adults (e.g., heart failure, COPD, diabetes, chronic kidney disease, osteoporosis), applying evidence-based geriatric principles and age-appropriate treatment targets.
Perform medication reconciliation, identify potentially inappropriate medications, lead deprescribing initiatives, and coordinate with pharmacists to reduce polypharmacy and adverse drug events.
Provide diagnosis, treatment, and follow-up for infections, wounds, skin integrity issues, and other common geriatric syndromes; order and interpret diagnostic tests and initiate appropriate treatment plans.
Conduct cognitive and behavioral health evaluations for delirium, dementia, depression, and anxiety; initiate appropriate referrals, pharmacologic and non-pharmacologic interventions, and caregiver education.
Lead advance care planning conversations, document goals of care and code status, and work with families and interdisciplinary teams to establish and implement advanced directives and palliative care referrals when appropriate.
Provide short-stay and longitudinal primary care visits in clinic settings, skilled nursing facilities, and through home visits or telemedicine, ensuring continuity of care and timely follow-up.
Collaborate with interdisciplinary teams (physicians, nurses, social workers, PT/OT, dietitians, pharmacists, case managers) to coordinate transitions of care, prevent readmissions, and create comprehensive discharge and transitional care plans.
Evaluate and manage behavioral disturbances and safety concerns in older adults, coordinating with facility staff and family to implement individualized behavioral plans and ensure a safe environment.
Interpret laboratory results, ECGs and imaging studies, adjusting treatment plans based on age-specific norms and comorbidities; consult specialists as needed for complex cases.
Provide acute medical services during on-call shifts for geriatric populations, including triage, stabilization, and disposition planning in coordination with supervising physicians.
Deliver preventive care services and screenings appropriate for older adults, including immunizations, osteoporosis screening, fall prevention counseling, and cancer screening per guidelines and life expectancy.
Perform procedures commonly required in geriatric practice (e.g., urinary catheter assessment and management, basic wound care, injections) according to clinic and facility scope of practice.
Document patient encounters thoroughly and timely in the electronic medical record (Epic, Cerner, or comparable EMR), including problem lists, care plans, medication changes, and billing-appropriate visit notes.
Communicate complex medical information compassionately and clearly to patients and families, providing education on disease processes, medication changes, prognosis, and community resources.
Coordinate referrals to specialty care, rehabilitation services, durable medical equipment (DME), and community-based supports (home health, Meals on Wheels, caregiver resources).
Participate in quality improvement initiatives aimed at improving geriatric care outcomes, reducing hospital readmissions, enhancing patient satisfaction, and meeting regulatory compliance for long-term care settings.
Support behavioral health and substance use evaluations, collaborate with mental health specialists, and assist with crisis intervention planning for high-risk older adults.
Administer and supervise telehealth visits and remote monitoring when appropriate to extend access to care, especially for mobility-limited or homebound patients.
Ensure compliance with regulatory requirements, Medicare documentation rules, SNF and LTC facility protocols, and facility-level infection control and safety standards.
Mentor and precept physician assistant students, nurse practitioner students, and junior clinical staff in geriatric assessment, documentation, and interdisciplinary collaboration.
Participate in multidisciplinary case conferences, family meetings, and care-planning sessions to align clinical care with patient-centered goals and optimize functional outcomes.
Identify social determinants of health impacting older adults (housing, food security, caregiver capacity), connect patients with community resources, and escalate needs to social work or case management.
Support institutional efforts around dementia-friendly care, staff education on elder abuse recognition and reporting, and programs to promote mobility, nutrition, and quality of life among residents and patients.

Secondary Functions

Lead or participate in training and educational sessions for facility staff and caregivers on geriatric best practices, polypharmacy, fall prevention, and communication strategies with cognitively impaired patients.
Assist with outpatient clinic operations including scheduling, triage, patient flow improvement, and coordination with ancillary services to enhance access and continuity for older adult patients.
Participate in data collection for clinical registries, quality metrics (e.g., vaccination rates, readmission rates), and performance dashboards that support value-based care initiatives.
Contribute to policy development and protocol standardization for geriatric care pathways, hospital-to-SNF transitions, and palliative care triggers.
Engage in case reviews and morbidity/mortality discussions focused on geriatric-specific outcomes to inform practice changes and continuing education.
Support practice growth by participating in community outreach, patient education events, and collaboration with primary care networks to increase referrals and integrated care.
Assist with credentialing, peer review activities, and compliance documentation required by facility administration and accrediting bodies.
Participate in research or pilot programs when available, including medication safety projects, fall prevention trials, or telehealth access studies targeting older adult populations.

Required Skills & Competencies

Hard Skills (Technical)

Comprehensive Geriatric Assessment (CGA): skilled at conducting multidimensional evaluations (medical, functional, cognitive, psychosocial).
Medication reconciliation and deprescribing strategies for polypharmacy risk reduction.
Cognitive screening tools: proficiency with MMSE, MoCA, Mini-Cog, and delirium screening instruments (e.g., CAM).
Chronic disease management for older adults: heart failure, diabetes, COPD, CKD, hypertension with geriatric-specific treatment goals.
Advanced care planning and goals-of-care documentation, including POLST/advance directive completion.
Wound care basics, urinary catheter management, and common bedside procedures performed in SNF/LTC settings.
Familiarity with EMR systems (Epic, Cerner, PointClickCare) and Medicare billing/documentation requirements for older adult care.
Telemedicine delivery and remote patient monitoring specific to geriatric patient needs.
Interpretation of labs, ECGs, and common imaging relevant to geriatric diagnostic workup.
Infection control practices and immunization management for older adults (influenza, pneumococcal, COVID-19).
Ability to coordinate post-acute care transitions and develop discharge plans that reduce readmissions.
Basic palliative care and symptom management (pain, dyspnea, nausea) for seriously ill older adults.

Soft Skills

Exceptional communication skills with older adults, families, and interdisciplinary teams; adept at difficult conversations and delivering readouts of complex assessments.
Strong clinical judgment, autonomy, and the ability to prioritize care for medically complex patients.
Empathy and cultural competence when addressing sensitive issues such as cognitive decline, elder abuse, and end-of-life planning.
Organizational and time-management skills to manage caseloads across multiple settings (clinic, SNF rounds, home visits).
Collaborative team player who leads and contributes to interdisciplinary care plans and quality improvement initiatives.
Problem-solving orientation with a focus on pragmatic, patient-centered solutions and resource optimization.
Teaching and mentoring capability to precept students and educate staff on geriatric care best practices.
Resilience and adaptability working with variable patient acuity, staffing models, and regulatory environments.

Education & Experience

Educational Background

Minimum Education:

Master’s degree from an accredited Physician Assistant program; graduation from ARC-PA certificated program.

Preferred Education:

Additional coursework or certification in gerontology, palliative care, or geriatric medicine (certificate programs, continuing education credits).

Relevant Fields of Study:

Physician Assistant Studies
Nursing or Advanced Nursing Practice (for lateral hires)
Gerontology, Palliative Care, or Public Health (continuing education)

Experience Requirements

Typical Experience Range:

1–5 years of clinical experience as a PA, with at least 1 year of experience in geriatrics, long-term care, skilled nursing, or primary care for older adults preferred.

Preferred:

2+ years working in geriatrics, SNF/long-term care, home health, or post-acute settings; demonstrated experience with interdisciplinary care coordination, Medicare regulations, and complex care planning for older adult populations.
NCCPA certification (PA-C), state PA license, BLS required; ACLS and geriatric-focused certifications preferred.