February 11, 2026
McKnight's Long-Term Care News
The workforce crisis facing nursing homes extends to the professionals responsible for the medical care of the residents. With that challenge comes opportunity.
Team-based care is already a core element of the geriatrics approach to care. Long-term care leaders should focus their attention on the team-based approach.
The true value of teams lies in taking advantage of the combined knowledge and skills of each team member. This is especially important when caring for vulnerable older adults. The complementary skills of physicians, nurse practitioners and physician associates are what make their combined value greater than the sum of their parts. Together, working as a team, we can meet the complex needs of our patients and their care teams.
The population we care for in today’s nursing homes is among the most complex that the medical field has ever encountered. We must devise and navigate the most appropriate treatment for frail nursing home residents with multiple advanced chronic conditions. This includes providing post-acute care, often after a recent ICU stay, for patients at high risk for rehospitalization.
There are not nearly enough physicians to provide for the required intensive medical care in nursing homes. Hence the need for physicians, nurse practitioners and physician associates to collaborate in the delivery of care.
The ”Enhancing Skilled Nursing Facilities Act” proposes to eliminate federal requirements for physicians to perform certain clinical services and provide oversight over the medical care of the complexly ill patients in SNFs. It is an understandable response to the shortage of physicians delivering medical care in nursing homes. We agree that this is an important issue.
Better together
Solutions to a limited physician workforce should focus on improved education, training and recruitment of physicians to the exciting and meaningful field of post-acute and long-term care medicine.
Our complexly ill and frail patients deserve the intentional collaboration of physicians, nurse practitioners and physician associates as well as other healthcare professionals such as pharmacists and the entire interdisciplinary team.
Improving the quality of care in nursing homes will require a focus on education and training for healthcare professionals, in addition to enhancing the synergies between all members of the healthcare team. The Post-Acute and Long-Term Care Medical Association is committed to educating the post-acute and long-term care physician, NP and PA workforce in the complexities of the care of our patients. Our many educational programs focus on all healthcare professionals who are discovering post-acute and long-term care medicine as a rewarding field.
Certified nursing home medical directors integrate their medical knowledge with an understanding of the complex systems and processes within which nursing homes operate. A competent medical director recognizes the many opportunities for the entire team to maximize the use of each other’s knowledge and skills.
PALTmed is committed to team-based care. Our certified medical directors have additional training in systems, quality and safety, and leadership. With their regulatory responsibility for coordination of medical care, the medical director fills an important role. States like California and Florida are developing solutions to increasing the number of certified medical directors.
It is time for those of us providing medical care in nursing homes to take the initiative. Team-based care does not happen organically; it requires leadership that intentionally supports and empowers collaboration. The geriatrics team-based approach to care maximizes everyone’s s1trengths. Today’s medical workforce shortage means that we must embrace this approach.
We must work together to assure that we all have the necessary education and training in the geriatrics approach to care. We are better together. We need to have all hands-on deck. Our patients will be safer for it.
Michael Wasserman, MD, CMD, is a geriatrician, certified medical director and former nursing home industry and quality improvement executive. He serves on the Board of PALTmed.
Sabine von Preyss-Friedman, MD, FACP, CMD, is the president of the Post-Acute and LTC Medical Association (PALTmed) and the chief medical officer for Avalon Healthcare and Caldera Care.
The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.
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