National Academies of Science Report Calls for Strengthening Medical Director Education and Transparency Requirements

April 8, 2022
Policy Snapshot

Last week, the National Academy of Sciences released a comprehensive report, The National Imperative to Improve Nursing Home Quality-Honoring Our Commitment to Residents, Families and Staff. The 600-page report identifies critical opportunities to improve the quality of care in nursing homes through both short- and long-term actions across a wide variety of domains, including delivery, payment, quality measures, and regulations. The overarching conclusion the report makes is that “the way in which the United States finances, delivers, and regulates care in nursing home settings is ineffective, inefficient, fragmented, and unsustainable.” The report calls for immediate action to initiate change in this setting and to ensure that any quality improvement initiatives are implemented using strategies that do not exacerbate disparities in resource allocation, quality of care, or resident outcomes. The report recommends that medical directors have a requirement for minimum education and national competency, as well as recommending routine collection and reporting of data, including demographic information, for medical directors, administrators, and directors of nursing.

The report lays out seven main goals:

  • Goal 1: Deliver Comprehensive Person-Centered Equitable Care that Ensures the Health, Quality of Life, and Safety of Nursing Home Residents; Promotes Resident Autonomy; and Manages Risk
  • Goal 2: Ensure a Well-Prepared, Empowered, and Appropriately Compensated Workforce
  • Goal 3: Increase Transparency and Accountability of Finances, Operations, and Ownership
  • Goal 4: Create a More Rational and Robust Financing System
  • Goal 5: Design a More Effective and Responsive System of Quality Assurance
  • Goal 6: Expand and Enhance Quality Measurement and Continuous Quality Improvement
  • Goal 7: Adopt Health Information Technology in All Nursing Homes

In a press release, AMDA applauded many of the report’s recommendations, including the establishment of training requirements and transparency of basic demographic information for medical directors. “We at AMDA believe that such requirements should exist on the federal level for all Medicare and Medicaid certified nursing homes,” says Society President Suzanne Gillespie, MD, RD, CMD. “The Society has advocated for such requirements for the last decade, and we are very hopeful that this new report provides the needed momentum toward achieving this goal.”

Likewise, AMDA supported the recommendation to improve training and work environment for the entire interdisciplinary team, including increasing minimum wage for front-line staff.

“We are so grateful to the NASEM Committee for their work in putting this thoughtful, thorough, and evidence-based report before us,” says Society Executive Director Christopher Laxton, CAE. “AMDA now calls on Congress and CMS to immediately begin to work with stakeholders to enact these vital recommendations, to improve the lives of those who live and work in our nation’s nursing homes.”

Read the full report.