Nursing facility medical directors should receive more training specific to long-term care, according to the American Medical Directors Association.

Residents of long-term care facilities often present particularly complex cases for clinicians, involving multiple chronic conditions, cognitive and functional loss and other debilities and illnesses. As a result, more investment is needed in training for medical directors of these facilities and physicians practicing in the LTC continuum, AMDA said in a letter to the Congressional Commission on Long-Term Care.

AMDA said it is developing a comprehensive framework laying out the competencies needed to practice post-acute and long-term care medicine. The association said these competencies go beyond the currently mandated certification requirements, which involve training in internal and family medicine and geriatrics.

The government’s clinical quality measures, which are in development, also are a concern.

“Many of the current clinical quality measures (CQMs) developed for the Physician Quality Reporting System (PQRS), Accountable Care Organizations (ACOs) and other similar programs were not written for, and in many cases do not meet the clinical needs of, the PA/LTC settings,” the letter states.

AMDA urged the commission to recommend CQMs more tailored for long-term care in its report to Congress.

The commission’s report will be released by the end of September, and will include recommendations to Congress on how to reform the U.S. long-term care payment and delivery systems. The 14-member panel accepted comments from the public through Aug. 27.

Click here to access the complete AMDA Aug. 26 letter.