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About Us

Enhanced Infection Prevention (IP) and Antibiotic Stewardship Programs (ASP) in long-term care facilities around the United States via teleconsulting services

Antibiotics are among the most commonly prescribed pharmaceuticals in long-term care settings, yet reports indicate that a high proportion of antibiotic prescriptions are unnecessary. The adverse consequences of unnecessary antibiotic use include adverse drug reactions or interactions, the development of Clostridiodes difficile infections, the emergence of multi-drug resistant organisms, antibiotic failure, increased mortality, and greatly increased costs.


The Centers for Disease Control and Prevention characterizes antibiotic resistance as “one of the world’s most pressing public health threats.” Unnecessary prescribing practices by clinicians and overuse of newer, broad-spectrum antibiotics when either no antibiotic or an older narrow-spectrum drug would suffice are believed to be the primary contributors to this problem. As a result of the above complexities, nursing homes are increasingly recognized as reservoirs of antibiotic-resistant bacteria.

Capsid Consulting's mission is to enhance the Infection Prevention (IP) and Antibiotic Stewardship Programs (ASP) in long-term care facilities around the United States via teleconsulting services. Through our interventions, we have a proven track record of decreasing unnecessary/inappropriate antibiotic use.  This in turn leads to improved patient outcomes and a decrease in operating costs.  Our facilities have a history of strong performance during surveys. 

Our consultants are members of IDSA, SHEA, ASM, ACP, and APIQ.  Capsid Consulting is a Massachusetts Senior Care preferred vendor.

Meet our Team

Our highly skilled team of doctors and nurses have many years of professional experience in the field to ensure that their partners get the best support possible.  

F. Ramzi Asfour, MD

F. Ramzi Asfour, MD

CEO and Founder

Dr. Ramzi Asfour has worked extensively in the treatment and prevention of infectious diseases since 2004. He has developed and managed infection prevention and antimicrobial stewardship programs for hospitals and long term care facilities while working in the field as a consultant, educator and project manager. Dr. Asfour has personally worked in over 30 long term care facilities and truly understands their unique concerns.


He has a proven track record of improving compliance, efficiency and ultimately patient care in numerous facilities. ​​Dr. Ramzi Asfour leverages his expert knowledge in health care based on his experience in public health (WHO and Columbia University) and in his over 10,000 unique patient visits in hospitals and LTCFs around the San Francisco Bay Area.

Dost Sarpel, MD

Dost Sarpel, MD

Medical Director and Chief Operating Officer

Dr Dost Sarpel completed his Internal Medicine Residency and Infectious Disease Fellowship at the George Washington University Hospital in Washington D.C.  After finishing his fellowship, Dr Sarpel has worked as a consultant for many hospitals throughout the East Bay area in California.  During this time he was a key part in managing Infection Control and Antibiotic Stewardship programs at numerous hospitals and long-term care facilities. 


Dr Sarpel also completed additional training in Viral Hepatology under the mentorship of Dr Douglas Dieterich, a world-renowned hepatologist. Dr Sarpel has noted expertise in treating patients with HIV, chronic hepatitis C, or chronic hepatitis B as well as patients with co-infection of these viruses, and has given many lectures as well as published several papers on these topics. 

Maryanne Caruso, RN, CPHQ, CIC

Maryanne Caruso, RN, CPHQ, CIC

Director of Infection Prevention and Clinical Education

Maryanne Caruso started her clinical career first as a Zoology major at UMASS Amherst, then in Boston as an RN graduating from Laboure College, class of 1981. Her clinical experience includes nursing in acute and intensive care, emergency, maternal child, and rehabilitation. In addition to direct patient care, she has extensive hospital director level experience in healthcare quality management, infection prevention & control, and clinical education, earning her health care quality management board certification in 2004, and infection prevention & control board certification in 2011.


While working as Director of Infection Prevention near Nashville Tennessee, she learned from the CDC’s Emerging Infections Program, OSHA, and Tennessee’s Syndromic Surveillance Program. Maryanne’s hospital performance improvement measures received commendations for best practice from The Joint Commission, and both acute and rehabilitation facility surveys with perfect infection prevention program results. Her Quality and ICP Director experience includes skilled care and rehabilitation settings, and a good understanding of the unique needs of patients and staff in the sub-acute and long-term care settings.


As Director of Clinical Education, Maryanne has been an effective energetic leader and innovator in staff and patient education. When not working on clinical projects, Maryanne enjoys gardening and raising puppies with her husband for service work.

Stephanie Leong, RN

Stephanie Leong, RN

Infection Preventionist

Stephanie Leong was born and raised in San Francisco. She developed a passion for nursing through volunteering her time at a nursing facility. She graduated from the University of San Francisco with her Master’s in Nursing Science.


Stephanie has been a Registered Nurse for 11 years and board certified in Infection Control with over 8 years of experience. She serves as a board member for the San Francisco Bay Area Association for Professional Infection Control Chapter. 

Tiffany Brackens
Tiffany Brackens headshot_edited.jpg

Tiffany Brackens

Executive Administrator

Tiffany's high-level organizational and administrative experience stretches the project management spectrum: Customer relationship management (CRM); market research; event coordination; webinar setups; grant proposal design; fundraising; and video editing, to name but a few. Enthusiastic, committed, flexible, and efficient, Tiffany's learning curves are short, and she is always excited to branch out for new challenges. Tiffany's range of interests extends to her work – bring on any project, and Tiffany is readily hands-on in both knowledge and execution. Detail-oriented, Tiffany welcomes all levels of a task, in any task.


Enhanced by her BS in Computer Science, Tiffany brings extensive technological savvy and people-skilled broad-mindedness to every professional role. She has excelled in a wide array of functions – from sales, billing, meeting planning, scheduling, training, and documenting and maintaining office processes. Tiffany is a dynamic, resourceful, and energetic individual who is comfortable with being the go-to person for anything related to the seamless running of an office.

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