Medicare Compliance & Reimbursement

What’s the proper role of a nursing home medical director? According to the HHS Office of Inspector General, it’s not quite as clear as it should be — despite the fact that legislation requiring nursing homes to hire a physician medical director has been on the books for more than 15 years.

In “Nursing Home Medical Directors Survey” (OEI-06-99-00300), the OIG surveyed medical directors in seven states and found that their chief functions appear to be quality improvement, patient services, residents’ rights and administration.

Beyond those categories, however, medical directors reported various other duties, indicating their job description can vary markedly between facilities.

The OIG worries, however, that it’s not always clear who is ultimately charged with ensuring that residents receive necessary care — the medical director, the attending physician, the administrator or the nursing home staff. The OIG suggests that the Centers for Medicare & Medicaid Services “continue to work directly with representatives of the nursing home industry, patient advocacy organizations, and physician-related associations in establishing, clarifying, and enhancing the medical director’s role.”

To see the report, go to http://oig.hhs.gov/oei/reports/oei-06-99-00300.pdf.