Absence of Medical Direction

According to a study published by the Journal of the American Geriatrics Society on September 2nd, more than one-third of nursing home facilities in the U.S. had no medical director present in the first quarter of 2023. That is ridiculous. Nursing homes need medical directors. 

Ҥ483.70(g)(1) The facility must designate a physician to serve as medical director.

§483.70(g)(2) The medical director is responsible for—
(i) Implementation of resident care policies; and
(ii) The coordination of medical care in the facility.

The facility must identify how the medical director will fulfill his/her responsibilities to effectively implement resident care policies and coordinate medical care for residents in the facility. This may be included in the medical director’s job description or through a separate facility policy. Facilities and medical directors have flexibility on how all the duties will be performed. However, the facility must ensure all responsibilities of the medical director are effectively performed, regardless of how the task is accomplished or the technology used, to ensure residents attain or maintain their highest practicable physical, mental, and psychosocial well-being.”

Many researchers from the University of California San Francisco, the California Association Long Term Care Medicine in Santa Clarita and the Long Term Care Community Coalition in NYC, analyzed the data from federal home staffing and payroll data from 2017 to 2023. 

Between 2017 to 2023, when a medical director was present, their time averaged an amount of 36 minutes per day, or 4.2 hours per week.

For-profit nursing homes had the lowest rate of medical director presence at 61.4%, while nonprofit and government run facilities at 71.3% and 66.5%.