Competencies Curriculum Domain I: Foundation

This is Domain I of V of AMDA - The Society for Post-Acute and Long-Term Care Medicine's Competencies Curriculum for Attending Physicians Practicing in Post-Acute and Long Term Care.

See below for information on content included in Domain I, taking the Competencies Curriculum, credit information, learning objectives, faculty, and more. To purchase the full bundle, click here.


Domain I Content:

Section 1.1 Application of Ethical Principles in Clinical Decision-Making

This section addresses conflicts that may arise in the provision of clinical care by applying principles of ethical decision-making.

  • Utilize the principles of ethical decision-making to resolve conflicts in actual cases by engaging the patients, families and the interdisciplinary team (IDT) in discussions of goals of care and develop a plan of care that reflects the discussion.

Section 1.2 Clinical Implications of Legal and Regulatory Requirements

This section presents content on providing support care that is consistent with but not based exclusively on legal and regulatory requirements.

  • Describe the pertinent regulatory elements as reflected in the Centers for Medicare & Medicaid Services State Operations Manual and other relevant transmittals from regulatory bodies.
  • Document information in the medical record consistent with pertinent legal and regulatory requirements.
  • Develop and implement a plan for regular rounds in the skilled nursing facility/nursing facility (SNF/NF) consistent with regulatory requirements and medical necessity.

Section 1.3 Recognizing and Adapting to Patient Limitations and Impairments

This section discusses interacting with staff, patients, and families effectively by using appropriate strategies to address sensory, language, health literacy cognitive, and other limitations.

  • Use pertinent strategies in actual cases to address sensory, language, health literacy, cognitive, and other limitations.

Section 1.4 Optimizing Communication with Patients and Families

This section addresses communication skills that foster positive interpersonal relationships with residents, their families, and members of the IDT.

  • Identify the strengths and weaknesses of various communication strategies (e.g. texting, email, telephone, face-to-face) with the patients, their families, and the IDT.
  • Describe the core elements of effective communication (e.g. verbal, non-verbal, tone, open-ended questioning) with patients, family members, and the IDT.
  • Apply effective communication strategies to actual cases.

Section 1.5 Culturally Sensitive Interactions with Patients, Families and Staff

This section presents content about how to exhibit professional, respectful, and culturally sensitive behavior towards residents, their families and members of the IDT.

  • Describe the core elements of professional, respectful, and culturally sensitive behavior.
  • Use the core elements to display positive professional, respectful, and culturally sensitive behavior towards residents, their families, and members of the IDT.

Section 1.6 Elements of Appropriate and Timely Practitioner Performance

This section reviews patient/resident care needs, visits, phone calls, and documentation in an appropriate and timely fashion.

  • Value and describe the benefits to the resident, facility, and the physicians of making rounds regularly/according to the patient needs in the SNF/NF and responding in a timely fashion to phone calls, texts, faxes, etc.
  • Develop a plan for regular rounding to meet the patient needs and an approach to respond effectively and in a timely fashion to communications including phone calls, texts, faxes, etc.


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More information:

Taking the Competencies Curriculum

The Competencies Curriculum is divided into five domains. While participants are encouraged to take the entire curriculum, individuals may choose to take domains as they please, in any order. Participants have 60 days (from enrollment) to complete each Domain.

Credit Information

Physician CME

AMDA – The Society for Post-Acute and Long-Term Care Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education for physicians.

The Society designates this activity, Domain I: Foundation (Ethics, Professionalism and Communication), for a maximum of 2.25 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.


This self-study activity has been pre-approved by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM) for a total of 2.25 management hours toward certification as a Certified Medical Director (CMD) in post-acute and long-term care medicine. The CMD program is administered by the ABPLM. Each physician should claim only those hours of credit actually spent on the activity.

Maintenance of Certification (MOC)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.25 MOC points and medical knowledge and patient safety credit MOC credit in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.


The following AMDA Education Committee members have financial relationships to report: Eric G. Tangalos, MD, CMD – Lilly, Pfizer: Consultant; Omnicare: P&T Committee Chair; all others have no relationships to disclose. The AMDA Competency Curriculum workgroup and faculty have no relationships to disclose. AMDA staff have no financial relationships to disclose.

System Requirements

To participate in the online curriculum, you must have the following system requirements:

  • Adobe Flash Plug-in
  • Internet Explorer 9+, Mozilla Firefox, Google Chrome, Safari
  • Broadband Internet connection
  • Also compatible with iOS and Android based tablets