Medical Director Professional Liability
What this clause says
Coverage is extended to the Medical Director solely for administrative services performed on behalf of the Facility, and does not extend to any Claim arising out of the rendering of, or failure to render, direct patient care.
What this actually means
Skilled nursing facilities are required to have a medical director, and the role is defined largely in administrative terms: oversight of clinical policy, coordination of care, and quality assurance. That administrative role is distinct from the individual practice of that physician treating individual residents, and coverage is usually drawn along exactly that line.
What it means for an operator
CMS conditions of participation at 42 CFR Part 483 require a designated medical director for a skilled nursing facility, which means the role exists whether or not anyone has thought about how it is insured. When a claim alleges that facility clinical policy was inadequate, it lands on the medical director in the administrative capacity, and the malpractice policy carried by the physician may exclude administrative or medical director services entirely. The result is a role that both policies believe the other covers. Resolve it explicitly: either endorse the medical director onto the facility program for administrative acts, or confirm in writing that the physicians carrier covers medical director duties, and make the answer a term of the medical director agreement.
How this evaluates
The Policy Checker applies these rules in order; the first match wins.
medical director covered is set -> Compliant: Medical director administrative acts are covered. Confirm the medical director agreement records which policy responds, so the two carriers do not each point at the other. medical director covered is not set -> Borderline: Medical director duties are a required role under CMS conditions of participation and frequently fall between the facility policy and the malpractice coverage carried by the physician. Confirm in writing which one responds.
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Check this term against your own program.
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Common questions about this clause
- Does the medical director need separate liability coverage?
- Who should be a named insured on a senior care liability policy?
- Who is liable when an agency nurse causes a claim at my facility?
- Is an elopement claim covered under my memory care policy?
- Does independent living need professional liability if there is no care license?