A medical director has to be more “engaged” than ever in its nursing home’s everyday operations at a time when facilities continue to see an influx of higher acuity patients, Dr. Justin Di Rezze, CEO of Theoria Medical, said.

Di Rezze said that while nursing homes were beginning to see more medically complex patients before the COVID-19 pandemic, hospitals continue to be overcrowded and overburdened with the patient population and are therefore discharging patients sooner.

“What’s going to happen is that skilled nursing facilities are going to be relied on to handle the highly acute patients that aren’t really sick enough to be in an ICU in the hospital, but they’re also not good enough to go home so they’re going to go to skilled nursing facilities, that’s really what’s already happening,” he said.


As a result, nursing homes need to be attentive to that acuity and develop protocols in place — led by the medical director — to care for “the sick of the sick.” Otherwise, rehospitalization rates “are going to shoot through the roof.” Di Rezze said.

Di Rezze spoke at Skilled Nursing News’ Clinical Executive Summit earlier this month, along with Joyce Turner, director of business innovation and strategic planning at Ciena Healthcare.

Responsiveness and a patient-first mentality are two key qualities Turner looks for when hiring a medical director. Making the right hire for an SNF can define the success of the entire health care organization, she said.

“There’s no one size fits all, so it’s critical you find a medical director that fits your unique needs for your organization,” Turner added.

On the topic of responsiveness, Turner said in addition to being visible and accessible, a medical director should also promote the use of technology, especially given the workforce strains the industry is facing.

Di Rezze echoed Turner’s thoughts on the importance of innovation and technology, adding that the health care industry has lagged 10-15 years behind modern-day trends and skilled nursing is even further behind.

And while it’s important to find a medical director who has the experience to treat complex patients, what can be even more crucial is finding a physician who has the ability to remain agile within the facility.

“The worst types of medical directors are the medical directors that are stuck in their ways and that are turned off to any type of innovation, any type of self-development or self-growth, and think that the way that they’re practicing medicine is the best way possible,” he said.

Entering the industry as a medical director himself, Di Rezze admitted he had his own misconceptions about post-acute care.

“A lot of the physicians that I know personally, they’re seeking opportunities like this, they just need to be presented with that opportunity,” he said.

Gone are the days when a facility kept a disengaged medical director who was affiliated with a particular hospital because they feared letting them go would mean they would lose referrals, Turner said.

“If you’re saving them money and they’re sharing in that savings with CMS, [the hospitals] don’t really care what doctor is doing that,” she said. “They just know that their patients are being taken care of. They’re not returning to the hospital, they’re keeping their costs down and they’re keeping their quality up, and that’s the bottom line.”

Photo by Muskan Anand from Pexels