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2022-04-12 11:15:00

April 7, 2022
Contact: Ellen Mullally

Columbia, MD – AMDA – The Society for Post-Acute and Long-Term Care Medicine applauds the many recommendations included in yesterday’s National Academies of Sciences, Engineering, and Medicine Report, The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families and Staff.

The report makes concrete recommendations to strengthen the role of the nursing home medical director for the first time since the OBRA 1987 law that established the requirement. This includes establishing minimum training and competency requirements, as well developing a publicly available national database of information about the basic demographics and training of the medical director, among others.

The report notes that the Centers for Medicare & Medicaid Services (CMS) currently does not “keep any record of the characteristics of nursing home medical directors (e.g., age, medical specialty, certification status, geriatric or medical director training, number of patients served, time spent in the nursing homes) in its databases, which makes research in this area challenging.” The report notes that such research and information about the role is critical to improving the quality of care in nursing homes. The state of California has taken the lead by passing legislation establishing medical director training and certification requirements as well as establishing a public database of 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.”

The Society also supports recommendations to increase training requirements for the entire interdisciplinary team. As the report notes, we need to improve the currently “inadequate foundation for a variety of geriatric related topics” for those working in nursing homes. This includes, as the report states, “nursing home administrators, directors of nursing, and directors of social services.” Likewise, we agree that we must improve working conditions, including raising the minimum wage for certified nursing assistants and licensed practice nurses who are vital to the care of patients and residents in our nation’s nursing homes.

Further, the Society supports recommendations to immediately address the inadequacy of health information technology adoption as well as other vital infrastructure necessary to work in the 21st century health-care system. This will provide increased opportunities for PALTC to meaningfully participate in innovative, value-based payment models, and thus to improve the efficiency of care. With technology investments that are now more than a decade old, the acute-care sector has long since moved into the 21st century, while the PALTC sector remains far behind. Those needing care move through the entire care continuum and it is past time to address our health-care system as a whole. This means making the same necessary investments and requirements in PALTC that have long been in place in acute care.

We especially appreciate the inclusion of the resident, patient, and family voice in the report, and we agree strongly with the report's opening assertion that “implementation of the committee’s integrated set of recommendations will move the nation closer to making high-quality, person-centered, and equitable care a reality for all nursing home residents, their chosen families, and the nursing home staff who provide care and support them in achieving their goals.”

“We are so grateful to the NASEM Committee for their work in putting this thoughtful, thorough, and evidence-based report before us,” said 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.”




AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit for more information.