The pandemic raised many discussions regarding senior care and aging services. Among them is whether medical directors should have a role in assisted living communities. During a session at the virtual annual conference for The Society for Post-Acute and Long-Term Care Medicine (AMDA), a panel discussed the implications of the increasing medical complexity of assisted living residents and a growing need for infection control expertise.  

They posited that the solution is to establish medical directors in assisted living communities. While the value of this role has been bandied about for years, the pandemic shone a bright light on the issue. As COVID spread, it became apparent that that infection prevention education and protocols were not always required, mandated, or even available in these settings. This is concerning, the panel suggested, particularly when 75% of assisted living residents have two or more comorbidities, and acuity among these individuals has increased over the years.  

While the concept of an assisted living medical director is new and somewhat controversial, AMDA panelist Dr. Dallas Nelson suggested that onsite medical directors can provide insight, expertise, and leadership for assisted living communities. Beyond infection prevention, a medical director can provide benefits that impact a community’s success and optimize resident care. A medical director can help improve individualized care, address family involvement and interventions, review incident reports, policies, and procedures, make care transition decisions, and oversee medication reconciliation processes.  

While it seems reasonable for continuing care communities to give nursing home medical directors responsibility for assisted living residents living on the same campus, the panelists opined that this is not always practical or helpful. In their view, nursing facilities and assisted living communities have different regulations and standards that warrant separate medical directors for quality and cohesive care.  

Although this issue is unlikely to be resolved soon, recent discussions highlight this increasing need in the post-pandemic world.   

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