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The House on Thursday introduced a bipartisan bill that would require nursing homes to report their medical directors’ credentials and background to the Centers for Medicare & Medicaid Services.

In order to improve public transparency, the Nursing Home Disclosure Act, HR8832 would also require CMS to publish the medical directors’ information on the Care Compare online tool. 

The proposed legislation aims to ensure that facilities are held accountable for hiring qualified medical directors, and to help consumers make more informed long-term care choices, according to its sponsors, Reps. Mike Levin (D-CA) and Brian Fitzpatrick (R-PA).

“It’s unacceptable that some nursing homes do not provide a full public accounting of who their medical director is,” said Rep. Levin. “Our bipartisan bill will rectify that and require transparency that families need to have faith in their nursing homes.”

Underreporting rampant

Federal legislation requires that Medicare-supported facilities have a physician as their medical director and that they supervise clinical care quality, policy and staff. Nursing homes are required to report all management level employees, but there is significant underreporting, according to AMDA-The Society for Post-Acute and Long-Term Care Medicine.

Only 30% of nursing homes reported staff hours for their medical directors in the first quarter of 2019, for example.

There has also never been a public listing of who these professionals are. Some facilities make the medical director’s information known, and others do not, industry advocates said.

The position does not have the visibility needed to foster industry-wide clinical problem solving, or for consumer availability and awareness, said Christopher Laxton, CAE, executive director of AMDA, in a Thursday roundtable briefing.

Medical directors fill a variety of roles depending on the services a nursing facility provides. Some are employed by nursing homes and others are contractors. Many serve two facilities or more, but without centralized data it is difficult to track these data points, or signs of care quality, he and his colleagues said.

Guidance sharing

In addition, with no registry of these providers, there is not a direct way to funnel and share clinical guidance to all nursing homes through their medical directors — a lost opportunity during the pandemic, Laxton added.

AMDA has long advocated for a listing of medical directors as part of push for improved clinical oversight in post-acute and long-term care settings.

“The COVID 19 pandemic has highlighted the impact of the medical director on a nursing home’s timely response to emerging scientific guidelines and implementation of effective resident care policies,” said Suzanne Gillespie, MD, president of AMDA. “The public identification of medical directors of nursing homes is a logical, important step in ensuring the quality of care in America’s nursing homes.”

“We’ve heard from consumers that they want access to good care. They want to be able to have skilled and trained providers who are available to them,” said Milta O. Little, DO, president-elect of AMDA, who has served as a medical director in long-term care. “They want primary care that’s continuous and comprehensive. As a system of care, we need to make that accessible, and we’re in a place where society is going to expect that of us,” she said.

AMDA is working on signing on more sponsors to help push the bill into the Omnibus Reconciliation Act, which is the next step toward passage.

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