Supervising Physician-Medical Director
The role of the Supervising Physician-Medical Director in a Home Health setting is to provide ongoing guidance in the development and implementation of patient care policies, including review and revision of existing policies.
The medical director's role involves collaborating with the HHA regarding the policies and protocols that guide clinical decision making (for example, interpretation of clinical information, treatment selection and monitoring of risks and benefits of interventions) by any of the following: licensed physicians; nurse practitioners; physician assistants; clinical nurse specialists; licensed, certified, or registered health care professionals such as nurses, therapists, dieticians, pharmacists, social workers, and other health care workers.
The medical director has a key role in helping the HHA to incorporate current standards of practice into patient care policies and procedures/guidelines to help assure that they address the needs of the patient.
Although regulations do not require the medical director to sign the policies or procedures, the HHA should be able to show that its development, review, and approval of patient care policies included the medical director’s input. This requirement does not imply that the medical director must carry out the policies and procedures or supervise staff performance directly, but rather must guide, approve, and help oversee the implementation of the policies and procedures. Examples of patient care policies include, but are not limited to:
• Admission policies and care practices that address the types of patients that may be admitted and retained based upon the ability of the HHA to provide the services and care to meet their needs.
• The integrated delivery of care and services, such as medical, nursing, pharmacy, social, rehabilitative services, which includes clinical assessments, analysis of assessment findings, care planning including preventive care, care plan monitoring and modification, infection control, transfers to other settings, and discharge planning.
• The availability, qualifications, and clinical functions of staff necessary to meet patient care needs.
• Patient formulation and agency implementation of advance directives (in accordance with State law) and end-of-life care.
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• Mechanisms for communicating and resolving issues related to medical care.
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• Systems to ensure that other licensed practitioners (e.g., nurse practitioners) who may perform physician-delegated tasks act within the regulatory requirements and within the scope of practice as defined by State law; and
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• Procedures and general clinical guidance for HHA staff regarding when to contact a practitioner, including information that should be gathered prior to contacting the practitioner regarding a clinical issue/question or change in condition.
The medical director helps coordinate and evaluate the medical care within the HHA by reviewing and evaluating aspects of physician care and practitioner services, and helping the HHA identify, evaluate, and address health care issues related to the quality of care and quality of life of patients.