FAQs

Yes, I understand! GMC does not fit into the usual clinical practice models. It is

•  A micro practice. The practice will have a limited number of members, approximately 60 – 80.
• Uses technology, partnerships (Legacy Medical), and home/facility/text/email/virtual visits to reduce overhead and increase patient accessibility to the provider
• Outpatient-based, focused on providing in-home care, in-facility care, or virtual care
• Provides primary and specialized geriatric core services

No, a concierge practice has a limited enrollment of patients but charges a membership fee for access to the practice and bills your insurance. 

Golden Medical Care is a micro practice with limited enrollment, like a concierge practice. However, there is no membership fee, and your insurance is billed for services. This limited membership assures accessibility and quality of care.

In short, this relationship allows Dr. Deb’s dream of a specialized geriatric micro practice to work. She supports Legacy Medical with medical leadership and mentoring of their certified nurse practitioners providing geriatric on-site primary care to elders who are homebound or living in a long-term care facility. In exchange, Dr. Deb receives access to EMR, billing and coding services, insurance and back-office support, and on-call support.

If Dr. Kullerd has accepted you or your loved one as a member of the GMC micro practice, she will be the individual responsible for responding to your healthcare needs. There may be times when, for a variety of reasons, Dr. Deb is not available, such as the birth of a grandchild, illness, travel, education or speaking obligations, etc. The Legacy Medical CNPs are her partners in geriatric care and will stand in for her.

With a doctor bag in tow, Dr. Deb loves being mobile and seeing members in their homes. She sees patients throughout the Northern Black Hills, Rapid City, virtually and via telemedicine. Yes, I’ve been asked, “Are you doing this out of the back of your car?” I can understand that perception. It is a model of practice that is designed to meet seniors’ needs and maintains the joy of practicing medicine for Dr. Deb. In the future, Dr. Kullerd will have clinic hours available through her association with Legacy Medical.

Great, anxious to meet you! I would suggest using the contact tab, enter you contact information and request a Meet and Greet call. During that time, we can discuss you concerns and decide on the most appropriate initial assessment and place to visit to meet your needs.

No, Centers for Medicare and Medicaid Services (CMS) no longer recognizes office/outpatient consultative CPT codes for payment of office/outpatient visits. Dr. Kullerd will gladly see you or your family member for a geriatric, palliative care, or cognitive consultative visit. She will forward her notes and thoughts to your physician/provider for their and your consideration. Her billings to your insurance will be based upon the level of complexity of the work done.

Yes, Dr. Kullerd will be delighted to help on a consultative basis. She will work with you to address your concerns. After the consultation, she can send her notes and recommendations to your PCP OR transition your ongoing care to one of the Legacy Medical CNPs. Frequently, long-term care facilities (assisted living or nursing homes) will require a history and physical 30 days prior to your admission or transition to that facility. Dr. Kullerd provides that service and facilitates that transition. Your follow-up care in the facility will be provided by one of the Legacy CNPs.

Golden references the "Golden Years of a person's life after a "certain age".  The Black Hills is our home and Gold can easily be branded to the Black Hills,  "Custer Gold Rush",  Homestake Gold Mine, and Black Hills Gold jewelry.  As a precious resource, gold can be easily associated with one's health being the most valuable resource in a person's life.  Our goal is to provide a level of geriatric primary care with a premium, "white glove" type of service of our members.  The Golden Girls with their humor, authenticity and resiliency are inspirational in their approach to the tributations of aging.   

GMC provides excellent geriatric care through visits per your preference (home, video, phone, facility). This includes usual primary acute care (aches & pains, skin rashes, colds/cough, etc), chronic care for medical conditions (Hypertension, Diabetics, Arthritis, COPD, etc), comprehensive dementia care, and palliative/end of life care. GMC provides visits to nursing home, skilled nursing/rehabilitation stays, and assisted living facilities. GMC provides support for care partners supporting you should you be dependent upon their care.

Of Course! Physician access is one of the greatest benefits of GMC’s micro practice. Because illness and injury do not respect regular office hours, you may call, text, or email Dr. Deb whenever you need.

We maintain high standards of patient privacy. We will never provide your health information to any third party unless you specifically ask that we do?

· At the initial appointment, you will identify who the practice can release information to (ROI, release of information) and your power of attorney (POA). For most people, individuals identified as POA are also identified as individuals to receive information about your care or health status. Dr. Deb encourages and supports discussion of your health values with your family and particularly the person identified as your POA. As our health declines and we can develop increasing difficulty caring for ourselves and possibly making decisions or understanding the complex choices associated with medical decisions, having a trusted person advocating for you becomes very important.

Thanks to the relationship with Legacy Medical, scheduling with Dr. Kullerd is coordinated thru exceptional staff working with Legacy Medical. To schedule a meet and greet, e-mail Dr. Kullerd at Deborah.Kullerd@legacymedical.com. OR use the contact tab on the website. She will get back to you in 24-48 hours. Call 1-(701) 516-4637, ext 122 and ask to schedule an appointment with Dr. Kullerd OR you can e-mail schedule@legacymedical.com to request an appointment.

· Typically, Dr. Kullerd will request that your pharmacy provide you with a year of refills, either #90 with 4 refills or #30 with 11 refills. Pharmacies will notify Dr. Kullerd and the Legacy Medical staff when you are coming to the end of your refill authorizations. If you are uncomfortable or have concerns, contact Dr. Kullerd’s supporting staff @ 1-(701) 576-4637 or e-mail Deborah.kullerd@legacymedical.com .

This is a scary situation. We are all worried about changes to our memory with aging and the possibility of developing dementia. Dr. Deb is well qualified to assess your cognitive status and work with you and your family to develop a strategy for addressing your cognitive issues and concerns. If you or your loved one is determined to have cognitive/brain changes or dementia, she will support you and your care partner in maintaining your physical and cognitive health, obtaining the support you will need for the future, and addressing changes as they develop. Dementia can be a difficult journey over usually many years, it is important that you and your loved ones continue to live full and meaningful lives. To prepare for the changes that come with this disease, it is important to build a team to support you, your caregiver and family. Dr. Deb will be an active member of this team.

Dr. Kullerd has extensive experience in working with patients living with serious illness and poorly controlled symptoms that suck the meaning and joy from their lives. She is certified in Hospice and Palliative Care Medicine. She can work with you and your goals to prolong your life by continuing life extending treatments and help with your symptoms. Give her a call and chat about options.

· This is a very difficult situation. The ongoing, relentless progression of dementia complicated by behavioral changes

makes caregiving a physically, emotionally and mentally exhausting role. Dr. Deb finds that every situation like this is unique. We need to work together to understand your situation and determine what are the options for you. Dr. Deb has worked in the field of long-term care and dementia care for the last 15+ years. Give her a call and chat about options.

This is a difficult time for a family or spouse. We have promised our loved one that we will keep them at home, but we are simply unable to continue. Dr. Deb can help you determine the resources that you need and options for a higher level of care, nursing home, assisted living or memory unit. If their life expectancy is less than six months, she can facilitate referral to hospice services.