Medical Director
Description of Specialty
The medical director is a physician who is involved at all levels of individualized patient care and supervision, and for all persons served by the facility. The medical director serves as the clinician who oversees and guides the care that is provided, a leader to help define a vision of quality assurance and process improvement, an operations consultant to address day-to-day aspects of organizational function, and a direct supervisor of the medical practitioners who provide the direct patient care. The medical director position is required by law under Title 42, Section 483 of the Code of Federal Regulations.
Educational Requirements
A medical degree (M.D. or D.O.), or comparable non-U.S. diploma with required licensure in the U.S.
Licensing Requirements
Varies by state, but requires a medical license (physician and surgeon).
Specialty Credentials Related to Geriatrics
AMDA—The Society for Post-Acute and Long-Term Care Medicine is the organization providing certification for nursing home medical directors. The certification is a Certified Medical Director (CMD) certificate and requires basic educational (core curriculum) and experiential components, as well as recertification every 7 years.
Scope of Services in Long Term Care Settings
Title 42 CFR §483.75 contains the general description of medical director services in skilled nursing facilities as follows:
483.75 (i) Medical director.
- The facility must designate a physician to serve as medical director.
- The medical director is responsible for—
- Implementation of resident care policies; and
- The coordination of medical care in the facility.
There may be other state-specific services required of medical directors, such as participating in employee health, which vary by state.
AMDA has further categorized the services of the medical director as follows:
- Function 1—Administrative
The medical director participates in administrative decision making and recommends and approves relevant policies and procedures.
- Function 2—Professional Services
The medical director organizes and coordinates physician services and the services provided by other professionals as they relate to patient care.
- Function 3—Quality Assurance and Performance Improvement
The medical director participates in the process to ensure the quality of medical care and medically related care, including whether it is effective, efficient, safe, timely, patient-centered, and equitable.
- Function 4—Education
The medical director participates in developing and disseminating key information and education.
- Function 5—Employee Health
The medical director participates in the surveillance and promotion of employee health, safety, and welfare.
- Function 6—Community
The medical director helps articulate the long-term care facility’s mission to the community.
- Function 7—Rights of Individuals
The medical director participates in establishing policies and procedures for assuring that the rights of individuals (patients, staff, practitioners, and community) are respected.
- Function 8—Social, Regulatory, Political, and Economic Factors
The medical director acquires and applies knowledge of social, regulatory, political, and economic factors that relate to patient care and related services.
- Function 9—Person-Directed Care
The medical director supports and promotes person-directed care.
More specific information on each of these domains is available at www.amda.com/governance/whitepapers/A11.cfm
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