Improving Patient Outcomes: The Impact of Medical Directors in SNFs

The Centers for Medicare and Medicaid Services (CMS) requires medical director presence at skilled nursing facilities (SNFs), and for good reason. Medical directors lead to a higher quality of care — up to 15% quality improvement compared to facilities without a medical director. 

Despite the value of a medical director, SNFs still encounter challenges in this area. Traditional approaches to medical directorship treat it like a part-time role that any experienced physician can fill. But is that enough? A dedicated medical director at your center, not just a part-timer, can make a noticeable difference.

Explore the benefits of dedicated medical directors and how the right approach can help your center overcome its existing medical director challenges. 

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The Role of Medical Directors in SNFs

Medical directors play key leadership roles at skilled nursing centers. These physicians oversee team collaboration, ensure compliance, and work to improve the quality of care at a center. Medical directors help to create a unified vision for a SNF to ensure all staff members work toward the same goal and provide the best possible support they can to patients. With such a complex patient population, a collaborative care environment is essential, and medical directors make it more accessible. 

Despite the value of this leadership role, medical directorship is often neglected. According to data from Q1 of 2024, 36% of nursing homes didn’t have a medical director. For those that did, medical director hours averaged about 36 minutes a day. Often, medical directorship is treated as a part-time role and an afterthought. Many medical directors are community physicians or hospitalists who split director hours with full-time hours at other facilities. 

SNF Challenges With Hospitalist Involvement in Skilled Nursing

Collaboration between hospitalists and SNFs can help these centers meet their medical director requirements, but this arrangement has limitations. Hospitalist involvement typically requires medical director hours on top of standard 12-hour shifts. For example, a hospitalist might work at a hospital for three 12-hour shifts and then report to the SNF for two off days. Some hospitalists might stop by a skilled nursing center before or after a 12-hour shift.

A hospitalist might have strong experience working with complex patient populations, but this part-time director structure leads to challenges, such as:

• Limited staff interactions: Brief visits to your facility mean your medical director has few chances to interact with staff. As the leader at your center, medical directors need these staff interactions to guide care and align everyone on the same goals. Limited interactions also reduce the possibility of conducting meaningful training with staff.
• Lack of familiarity with SNF needs: Hospitalists have experience with care in a hospital setting. In these cases, patients are often unstable and have complex care needs that need regular intervention. At a SNF, patients are more stable, but their stay is typically more dedicated to managing conditions than curing problems. This shift can be challenging for hospitalists to manage, and they may be more inclined toward rehospitalization over rehabilitation. 
• Fragmented, inconsistent care: Making infrequent appearances at your facility often leads hospitalists to provide inconsistent treatment. A lack of continuity can lead to declines in care quality as well as missed health developments and poor care choices as a result. 
• High turnover: Working with a hospitalist who splits their attention with a full-time hospital role often comes with high turnover. These providers are overworked and burnt out. It’s not uncommon for them to reach a point where they need to leave your center to cut down their hours. High turnover means you find yourself with a new medical director frequently, and every new provider is unfamiliar with your patient population and your staff. 

The Link Between Medical Directors and Patient Outcomes

Despite these challenges in scheduling, the expertise that hospitalists provide as medical directors can lead to significant improvements in care outcomes. With a consistent presence, medical directors can improve patient outcomes through:

• Care coordination: A dedicated, present medical director strengthens care coordination between providers to ensure all therapies support better care outcomes. 
• Communication: Leadership from a medical director ensures SNF staff and care teams remain communicative with one another. Shared goals can also encourage stronger communication with patients. Verbal communication correlates positively with patient satisfaction, improved health literacy, and improved physical and mental health. 
• Staff development: Training led by medical directors can make SNF staff more effective care providers. Building knowledge, skills, and abilities (KSAs) helps to improve teamwork effectiveness, contributing to improved care outcomes. Staff development can also improve staff satisfaction and encourage higher retention rates that help your center build a more experienced team.
• Regulatory compliance: SNFs must align with standards set by CMS, and medical directors make that compliance possible. CMS standards are designed to improve safety and care outcomes in a skilled nursing facility. Plus, the higher reimbursement rates for improved care outcomes can also encourage stronger patient care.

First Docs: A Solution for SNFs

At First Docs, we see how the current systems aren’t working as they should. The benefits of a medical director are clear, but the busy, overworked hospitalists filling these roles are making it harder to see the results. 

With First Docs filling in your medical director role, you can address the gaps left by community hospitalists. We improve patient outcomes in SNFs with a dedicated medical director presence. Our physicians have hospitalist training and are on-site five to seven days a week to ensure attentive clinical attention for your patients and collaboration with your staff. Our physicians also work at fewer sites to provide the focus and attention your patient population needs.

First Docs also provides ongoing training to our physicians to help them fulfill the medical director role. Your First Docs medical director offers:

• Strong collaboration with your SNF staff
• Alignment with compliance requirements
• Proactive patient care
• Application of best clinical practices
• QAPI meeting leadership
• Ongoing training with SNF staff to align with goals
• Support for value-based care objectives

With these areas working together, First Docs medical directors help to reduce hospitalizations and improve quality measures for better care outcomes, more satisfied patients and a more positive facility reputation.

Get Started With First Docs at Your SNF

First Docs is a physician-first group dedicated to correcting the shortcomings of the healthcare system. With our approach to medical directorship, delivering quality care in skilled nursing facilities is within reach. Our dedicated physicians improve patient care with an increased presence at your facility, improved collaboration with your staff, and ongoing leadership to drive quality measures. 

See the difference First Docs can make at your SNF. To learn more, get in touch with us today.

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