Medical directors of nursing facilities/skilled nursing facilities oversee both the implementation of resident care policies and overall coordination of medical care.1,2 There are federal requirements or F-tags that directly pertain to the role of the medical director and their role in improving quality. These Tags are located in the State Operations Manual (SOM) in F-Tag 501, Medical Director and F-Tag 520, Quality Assessment and Assurance.
Medical Director, F-Tag 501, states medical directors are responsible for implementing resident care policies and coordinating medical care in the facility. While regulation requires only that a physician be part of the Quality Assessment and Assurance committee, F-Tag 520, notes that since the medical director is responsible for the implementation of resident care policies and coordination of medical care, the medical director’s presence on the committee enhances its function.
Many clinically based Interpretative Guidelines associated with various F-tags imply the medical director’s oversight and responsibility roles as they pertain to quality assurance and quality improvement, but are not clearly delineated as to extent, methods, or authority. The medical director’s broad mandate impacts the quality of life of residents in all areas affected by medical care. Within this mandate, the provision of quality medical care in a resident-centered environment includes the optimizing of the most practicable level of resident functioning, addressing nutritional needs, and maintaining dignity of the residents. All resident care policies aimed at providing medical care fall into this purview consistent with federal regulations. The role of the medical director in promoting quality in the long-term care facility will be the focus of this white paper.