Facility Relationships

Our post-hospitalist relationships within facilities can take many forms. We can function as an attending physician, a PCP or the medical director.

Our post-hospitalist functions for each are described as follows:

• Attending Physician: A licensed physician who provides supervision over the medical care of each patient in a post-acute facility (42 C.F.R. §483.40 – physician services).  Specifically, the facility must ensure that: (a) the medical care of each patient is supervised by a physician; (b) another physician supervises the care of the patient during the attending physician’s absence; (c) at each visit, the attending physician reviews the patient’s total program of care, including medications and treatments, must write, sign, and date progress notes and sign and date all physician orders.

• Primary Care Physician (PCP): A licensed physician who provides the required supervision over the medical care of each patient who is enrolled in a managed health care plan.  They may also function as the patient’s attending physician while the patient is a resident of a post-acute facility, but typically does not follow patients or attend to them while they are a resident of a post-acute or long-term care facility

• Medical Director: In November 2005, CMS implemented their revised regulations (F501), which require each facility to have a medical director who is responsible for the implementation of resident care policies and coordination.  These two tasks provide the basis for the functions and roles required of a medical director. The medical director is required to be knowledgeable about current standards of practice in post-acute and long-term care.  They are also expected to coordinate and oversee related practitioners.  The medical director provides clinical leadership regarding application of current standards of practice and new or proposed treatments, practices and approaches to care.  His/her input promotes the attainment of optimal resident outcomes, which may also be influenced by factors, such as resident characteristics and preferences, attending physician actions and facility support.