Competencies Curriculum Domain II: Medical Care Delivery Process

This is Domain II 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 II, taking the Competencies Curriculum, credit information, learning objectives, faculty, and more. To purchase the full bundle, click here.


Domain II Content:

Section 2.1 Applying the Care Delivery Process to Patient Care

This section reviews managing the care of all post-acute and long-term care (PALTC) patients by consistently and effectively applying the medical care delivery process including recognition, problem definition, diagnosis, goal identification, intervention, and monitoring progress.

  • Describe the components of the medical care delivery process in managing PALTC patients.
  • Apply the medical care delivery process (problem recognition, assessment, management and monitoring etc.) consistently in providing PALTC.

Section 2.2 Developing a Person-Centered Evidence-Based Medical Care Plan

This section discusses developing, in collaboration with the interdisciplinary team (IDT), a person-centered, evidence-based medical care plan that strives to optimize quality of life and function, within limits of an individual’s medical condition, prognosis, and wishes.

  • Describe the composition of an IDT and the roles of the various team members.
  • Value patient-centered approaches in the care planning process by engaging the patient and the family to identify patient/ family goals.
  • Develop medical care plans that are consistent with patient/family values and goals.
  • Incorporate information from the IDT to improve patient/resident function and optimize patient/resident quality of life and dignity.

Section 2.3 Identifying and Incorporating Prognosis into Care Decisions

This section focuses on estimating prognosis based on a comprehensive patient/resident evaluation and available prognostic tools, and discusses the conclusions with the patient/resident, their families (when appropriate), and staff.

  • Demonstrate the use of prognostication tools in the management of PALTC patients.
  • Facilitate discussion of current and proposed treatment with clinicians, facility staff, and patient/family in relation to patient prognosis and goals.

Section 2.4 Principles of Palliative and End-of-Life Care

This section features content on identifying circumstances when palliative and/or end-of-life care (e.g. hospice) may benefit the patient/resident and family.

  • Compare and contrast the elements of curative, palliative, and end-of-life care.
  • Discuss the provision of palliative and/or end-of-life care with and without formal hospice enrollment.
  • Identify personal beliefs and values that may inhibit or facilitate the provision of patient-centered, end-of-life care.

Section 2.5 Developing Effective Palliative and End-of-Life Care Plans

This section focuses on developing and overseeing, in collaboration with the IDT, an effective palliative care plan for patients/residents with pain, other significant acute or chronic symptoms, or who are at the end-of-life.

  • Respect the use of advance care directives and palliative care approaches by adopting them in the care planning process.
  • Develop and implement care plans that are informed by advance care directives, utilize palliative care approaches, and incorporate input from the IDT and the patient/family values and goals.
  • Develop plans in collaboration with the IDT to address pain and other acute and chronic symptoms in patients at end-of-life.


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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 II: Medical Care Delivery Process for a maximum of 2 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 2.0 clinical 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 2.0 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