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Senior Living Liability

Skilled nursing

Is the medical director covered under our policy?

Often neither policy clearly does, which is the problem. A certified skilled nursing facility must have a designated medical director under federal requirements, so the role exists whether or not anyone has decided how it is insured.

The role is defined largely in administrative terms: oversight of clinical policy, coordination of care, quality assurance. When a claim alleges facility clinical policy was inadequate, it lands on the medical director in that administrative capacity, and the malpractice policy carried by the physician may exclude administrative or medical director services entirely.

Resolve it explicitly rather than by assumption. Either endorse the medical director onto the facility program for administrative acts, or obtain written confirmation that the physician carrier covers medical director duties, and make whichever answer applies a recorded term of the medical director agreement.

Source: CMS, 42 CFR Part 483

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