1. (1) Each nursing home licensee must have only one physician who is appointed as Medical Director.
2. (2) (a) The Medical Director must be a physician licensed under Chapter 458 or 459, F.S., and beginning on January 1, 2026, must hold an active certification as a medical director or be in the process of seeking such certification. Recognized certifying or credentialing organizations include the American Medical Directors Association now known as the Post-Acute and Long-Term Care Medical Association (PALTmed).

3. (b) For the purpose of this rule, “in the process of seeking such certification” means the medical director is actively engaged in obtaining certification as evidenced by his or her enrollment and participation in the PALTmed “Core Curriculum on Medical Direction in Post-Acute and Long-Term Care” program or other required certification program education in clinical or management topics for post-acute and long-term care.

   1. For a medical director appointed before January 1, 2026, the individual must complete certfication or recertification, if applicable, by December 31, 2028.

   2. For a medical director appointed on or after January 1, 2026 who is not certified, the individual must complete certification within three years from the date of appointment as the medical director of a nursing home facility.

4. (c) A physician must have his or her principal office within 60 miles of all facilities for which he or she serves as Medical Director. The principal office is the office maintained by a physician as required by Section 458.348 or 459.025(3), F.S., and where the physician delivers the majority of medical services. The physician must specify the address of his or her principal office at the time of becoming Medical Director. The agency may approve a request to waive this requirement for rural facilities that exceed this distance requirement as outlined in Section 120.542(2), F.S. A rural facility is a facility located in a county with a population density of no greater than 100 persons per square mile, which is at least 30 minutes of travel time, on normally traveled roads under normal traffic conditions, from any other nursing home facility within the same county.
5. (d) The Medical Director must visit the facility at least once a month. The Medical Director must review all new policies and procedures; review all new incident and new accident reports from the facility to identify clinical risk and safety hazards. The Medical Director must review the most recent grievance logs for any complaints or concerns related to clinical issues. Each visit must be documented in writing by the Medical Director.
6. (3) A physician may be Medical Director of a maximum of 10 nursing homes at any one time. The Medical Director, in an emergency where the health of a resident is in jeopardy and the attending physician or covering physician cannot be located, may assume temporary responsibility of the care of the resident and provide the care deemed necessary.
7. (4) The Medical Director must meet at least quarterly with the risk management and quality assessment and assurance committee of the facility.
8. (5) The Medical Director must participate in the development of the comprehensive care plan for the resident when he or she is also the attending physician of the resident.
9. (6) Each nursing home facility must provide information on the facility’s appointed medical director to the Agency including proof of certification or progress towards certification for the medical director. This information must be reported to the Agency as part of the nursing home’s licensure application for initial, renewal, change of ownership, or as the medical director changes.

Rulemaking Authority 400.141, 400.23 FS. Law Implemented 400.141(1)(b), 400.23 FS. History–New 8-2-01, Amended 12-21-15, 5-5-26.