From serving high-acuity patients efficiently to navigating complex regulations, long-term care (LTC) and skilled nursing facilities (SNFs) face many operational challenges daily. Some of these challenges have even led many centers to downsize. According to the 2024 Access to Care report, 20% of nursing homes have closed a floor, wing, or unit due to labor shortages since 2020. More than 700 centers have closed altogether in the same period, displacing over 28,000 residents.
Many of the challenges that SNFs face stem from the absence of an engaged medical director. While the Centers for Medicare and Medicaid Services (CMS) requires every center to have a medical director, not every medical director goes beyond the bare minimum. That’s where First Docs is different.
We recognize that strong medical directorship can solve many of the issues SNFs face by helping healthcare teams proactively and strategically address common challenges. To make a real difference, medical directors cannot show up just to check boxes — they must be engaged in driving quality improvement. Our medical directors are committed to a consistent on-site presence, actively participating in quality assurance and performance improvement (QAPI) meetings, providing proactive hands-on care, and leading teams with supportive, clinical expertise.
A committed medical director can help solve the following five operational challenges.
Care coordination can be difficult in SNFs and LTC facilities. Often, disjointed systems and processes create silos between centers and departments. As a result, clinicians struggle to access comprehensive, up-to-the-minute information about patients’ conditions and treatment plans, impacting their ability to deliver the best care possible.
Although healthcare providers know that care coordination is critical in supporting patient health, gaps in care transitions persist, contributing to consequences like delayed treatments, duplicate testing, or unnecessary hospitalizations. These, in turn, increase healthcare costs for patients and residents, decrease their satisfaction, and potentially cause harm.
Our medical directors improve care coordination by working closely with clinical teams, ensuring providers are on the same page about each patient’s medical needs and treatment goals. They take time to build partnerships with feeder hospitals and make sure patient records contain all the necessary details to facilitate seamless care transitions. Our medical directors also take a proactive approach to care, prioritizing early intervention and allowing more time for effective care coordination.
The CMS places immense regulatory pressure on SNFs, with requirements like QAPI program implementation and Patient Driven Payment Model (PDPM) compliance. Adherence to CMS regulations requires detailed documentation, adding to the administrative burden of already-overworked centers.
Additionally, CMS regulations constantly evolve, requiring SNFs to have systems to stay informed of updates. Without strong leadership, compliance becomes a burdensome way to avoid fines and ensure reimbursement rather than an opportunity to improve patient outcomes.
First Docs medical directors transform compliance from a never-ending checklist into an integrated aspect of leadership. They prioritize QAPI meeting attendance, effectively document QAPI initiatives, and help teams identify and strategically address compliance risks.
Our medical directors also take the lead on PDPM optimization. By ensuring meticulous care coordination and proactively managing patient conditions, our physicians make value-based care a natural aspect of SNF workflows.
Many SNFs struggle to reduce hospital readmissions, impacting patient well-being and SNF financial performance. Numerous factors contribute to this challenge, including poor care coordination and high patient acuity.
Today’s hospitals face pressure to discharge patients faster due to financial incentives, staffing shortages, and occupancy limits. Sending high-acuity patients to SNFs lacking strong clinical leadership increases the risk they’ll be rehospitalized due to the inability to initiate timely interventions. Almost a quarter of patients admitted to SNFs are readmitted to hospitals within 30 days.
High readmission rates can have severe consequences — not just on patients who may suffer increased financial burden and emotional distress from readmission, but also for SNFs. High readmission rates can lead to financial penalties due to the SNF Value-Based Purchasing Program, as well as lost revenue from shortened stays and lower CMS star ratings.
All of our medical directors are trained in internal medicine and serve as attending physicians in addition to fulfilling leadership roles. They consistently spend hands-on time with patients and residents, enabling them to recognize signs of deterioration early so they can be addressed before they become acute issues requiring rehospitalization.
Further, by facilitating care coordination between hospitals and SNFs and devising comprehensive post-discharge plans, our medical directors equip healthcare teams with a detailed roadmap to deliver high-quality care, effectively manage chronic conditions, and prevent complications — ultimately reducing rehospitalizations.
High turnover and staffing shortages have been ongoing challenges for SNFs and LTC facilities. For example, according to the 2024 State of the Sector Report, nearly all nursing homes have open jobs, and 94% claim it’s difficult to recruit new staff.
When there’s a staffing shortage, current employees are overstretched, which leads to burnout, decreased morale, and eventually turnover. For SNFs, this means increased costs related to replacing and training new staff or paying overtime. High turnover also impacts patients, disrupting continuity of care and leading to lower satisfaction.
With First Docs, your team members are never left to fend for themselves, regardless of whether your center struggles with a labor shortage. Our medical directors support your healthcare staff by offering expert mentorship, collaborating with them to make sound decisions quickly, and empowering them to solve issues confidently. Their consistent on-site presence can take the pressure off of your nurses to overcome challenges alone. As a result, our medical directors can help boost morale and create a more stable and collaborative work environment.
Most skilled nursing facilities have best practices — but that doesn’t mean staff consistently follow them. When a labor shortage becomes a critical concern, staff may feel pressured to rush through processes and unable to follow best practices step-by-step. Other factors, like inadequate training and a culture of reactivity instead of proactivity, can hinder an organization’s consistent adherence to best practices. This can compromise patient well-being and potentially lead to inconsistent patient outcomes.
Our medical directors do not passively stand by and watch best practices be abandoned. Rather, they work closely with SNFs to develop, standardize, and implement evidence-based protocols across the SNF. They monitor and guide adherence to the protocols they help create and implement continuous improvement cycles to ensure a center’s best practices drive the desired outcomes.
When it comes to the variety of challenges faced every day, most SNFs have their hands full. Committed medical directors provide the leadership needed to navigate complex challenges effectively, develop a collaborative work environment, and support the health and well-being of patients and residents.
Choose First Docs for medical directors who are uniquely positioned to help your center overcome its most pressing challenges. We are a leading provider of internal medicine physician services, serving acute and post-acute care facilities nationwide. Our medical directors bring expertise in geriatric care and are dedicated to value-based care models.
Partner with First Docs and gain a trusted leader who will strengthen your care team, boost operational performance, and help your SNF deliver exceptional outcomes that set you apart.