June 23, 2025
The Office of Inspector General (OIG) recently launched an official evaluation into how nursing homes engage their medical directors. The evaluation will focus on the accuracy of reported work hours and the fulfillment of required duties. The initiative follows concerns about the validity and utility of data submitted to the Centers for Medicare & Medicaid Services (CMS) Payroll-Based Journal (PBJ).
Medical directors are critical in ensuring quality care in nursing homes by implementing resident care policies, coordinating medical services, and contributing to quality assurance efforts. However, inconsistencies in PBJ-reported hours have sparked questions about the adequacy of oversight and engagement in these vital roles.
The OIG’s evaluation will examine:
- The extent to which medical directors performed required duties in nursing homes
- The extent to which PBJ data on medical director hours are accurate and useful for oversight
- Opportunities to improve oversight and transparency of nursing homes' engagement and funding of medical directors through existing data or other monitoring mechanisms
PALTmed had anticipated this evaluation and recently met with OIG representatives. The meeting allowed for open dialogue around the challenges and nuances of the medical director role, and PALTmed welcomed the opportunity to contribute to a more robust understanding of medical director involvement in their facilities. PALTmed has long believed that transparency around the medical director role is very important, and that’s why we have fought hard and introduced legislation to make the medical director's name and credentials easily available to the public.
The OIG’s final report, Monitoring Nursing Homes’ Engagement of Medical Directors, is expected sometime in 2026.
See the related McKnight’s Long-Term Care News article for more: SNF medical directors cautiously optimistic about fed plans to examine their work.
