Since 1974, federal Medicare regulations have required a licensed physician to serve as the Medical Director in all nursing homes. A Medical Director's primary duty is to oversee the quality of medical care provided to patients in skilled nursing facilities. This is usually done with the help of an administrator to assist in the supervision of the many doctors and nurses usually working in a nursing home.
Due to the Medical Director's broad set of responsibilities, the American Medical Directors Association (AMDA) breaks down a Medical Director's role into four main categories: Physician Leadership; Patient Care - Clinical Leadership; Quality of Care; Education, Information and Communication. Each of these categories has its own unique set of duties:
1. Physician Leadership
- Ensure a sufficient ratio of nursing staff to patients
- Establish physician performance guidelines
- Monitor performance of other health care providers such as RNs, LPNs, and nurses aides
Facilitate positive feedback on performance
2. Patient Care - Clinical Leadership
- Develop policies and procedures relating to patient care that conform to state and federal law
Respond to all government surveys and facilitate all state inspections
3. Quality of Care
- Oversee a facility quality assurance program
- Implement infection control policies into facility procedures
Promote health and safety among residents and staff
4. Education, Information and Communication
- Keep staff current on the latest guidelines and practice standards
- Represent the facility in both community and professional settings
- Establish and maintain relationships with other health care organizations
This structured break down of a Medical Director's roles and responsibilities came after the release of a 2001 Institute of Medicine report entitled Improving the Quality of Long Term Care. The report called for Medical Directors to be given more authority in skilled nursing facilities, but also to be more accountable for what happens in their nursing home.
The AMDA revised its existing standards with the vision of creating more focused and dedicated medical staffs from the top down in skilled nursing facilities. While these facilities are certainly businesses, the ultimate goal is to provide quality medical care and treatment to patients. Since lives are at risk, Medical Directors and their staff must be held to the highest standards and should be held accountable when they breach their duty of care or breach any rules, regulations, policies, procedures or standards.
Increased Safety for Increased Aging Population
In the wake of the aging baby boomer population, ensuring that nursing homes properly adhere to these standards of care can be the key to reducing accidents and injuries. In Connecticut alone, individuals age 85 and older who will need nursing home care are expected to grow by 70 percent in the next 20 years. This huge increase in the number of individuals requiring nursing home care only increases the potential for future Connecticut nursing home injuries to occur.