I honestly cannot tell you the last time a DON or Administrator said, “Oh, we love our medical director,” so if you love yours, hang on tight and do not let them move on. That may sound a little tongue-in-cheek, but it also shows how important medical director oversight has become in today’s senior care environment. Years ago, many communities treated the medical director role as more of a figurehead position. They did not always define the responsibilities clearly. Many medical directors also carried a full caseload of residents and provided their care personally.

That is not the case today. In fact, the role has expanded so much that some medical directors now choose to step away from the title and focus only on resident care. I believe physicians need a more active role in the operations of our communities. They should oversee other professional providers, guide the overall direction of care, and help develop and implement policies and procedures.

Now for the part that should really get your attention. In a recent article from McKnight’s Long-Term Care News examining federal plans to look more closely at the work of SNF medical directors, the Office of Inspector General put this role under a brighter spotlight. That scrutiny grew after earlier findings showed that as many as 36% of U.S. nursing homes did not report any medical director hours at all. Communities must report medical director hours through the CMS Payroll-Based Journal system. That requirement reminds us how closely these agencies and reporting systems connect.

The bigger issue is not simply whether a medical director’s name appears on paper. The real issue is whether the medical director performs the work, documents it, and supports it clearly. The OIG’s Nursing Facility Industry Segment-Specific Compliance Program Guidance reinforces the need for leadership accountability and operational transparency. My advice? Buckle up, hold your medical director accountable, and encourage open dialogue, because medical director oversight can no longer sit quietly in the background.

Stay well and stay informed!