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"
