Long Term Care: Role of the Nursing Home Medical Director

Each nursing home must have a Medical Director. Usually it may be a Doctor who has visiting privileges with the home. The Doctor may receive compensation from both the nursing home and the patient (via direct payment, Medicare, Medicaid, or insurance).

It would seem that often these forces may be in conflict; however it is seldom that the Medical Directors are questioned in this regard. Since they are "hired" by the nursing home they can be held somewhat responsible for the actions of the home. Of course the reverse is also true; the nursing home has some responsibility for the actions of the Doctor.

Typical usual duties of a nursing home Medical Director

The usual duties of a Medical Director of a nursing home may be to:

• Participate in administrative decision making, and recommend and approve policies and procedures
• Organize and coordinate physician services and services of other professionals as they relate to patient care
• Participate in the process to ensure the appropriateness and quality of medical and medically-related care
• Participate in the development and conduct of education programs
• Help articulate the facility's mission to the community, and represent the facility in the community
• Participate in the surveillance and promotion of the health, welfare, and safety of employees
• Acquire, maintain, and apply knowledge of social, regulatory, political, and economic factors that relate to patient care services
• Provide medical leadership for research and development activities in geriatrics and long-term care
• Participate in establishing policies and procedures in order to assure that the rights of individuals are respected
• Develop and revise policies and standards for patient care, infection control, and quality assurance
• Communicate with physicians regarding policies and standards, along with specific patient problems
• Assist in inservice training of nursing home staff
• Arrange for medical coverage when necessary
• Help to ensure that emergency care is available
• Participate in comprehensive care planning

Source: Modified from Levenson in "Medical Direction in Long-term Care"

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