Administrative
Meet documentation requirements as governed by the facility, and state and federal law
Provide residents, caregivers, and facility staff contact information to respond to calls regarding care
Provide on-call roster to facility staff
Provide an informed and credentialed alternate physician(s) for cross-coverage
General
Assess residents' decision-making capacity, and develop advance directives
Abide by facility policies, including infection control procedures
Assist in care planning and coordination
Become familiar with federal and state regulations
Become involved with committees and medical staff issues
Liaison with residents, families, caregivers, and facility staff
Perform comprehensive assessment of the resident
Practice preeminence of resident autonomy and self-determination, when possible
Provide care that is based on medical necessity
Resident care
Care planning and coordination, transfers, discharges:
Facilitate safe transfers between care environments (e.g., from nursing home to hospital)
Implement interdisciplinary approach to care (e.g., cancer screening; health maintenance; immunizations; behavioral interventions; fall prevention; palliative and hospice care; polypharmacy; management of nutrition, hydration, pressure ulcers, and infections)
Emergencies
Develop evaluation and treatment plan for emergencies
If an emergency occurs, review circumstances and possible causes, and formulate measures (if applicable) to prevent similar events
Liaison with nursing home medical director*
Liaison with consultant pharmacists, and review medications
Supervise midlevel health care professionals
Physician may delegate care to midlevel health care professionals if within their scope of practice; follow facility policy
Some tasks must be performed by a physician
Visitation intervals
Admission visit: the physician should examine residents within 72 hours of initial nursing home admission, unless a documented physician examination occurred within the previous five days; this visit establishes the level of care
Scheduled visits: the physician should visit the patient within 30 days of the initial examination, then once every 30 days for the first 90 days and at least once every 60 days thereafter
Interim visits should occur for acute, emergency, or unusual medical/behavioral issues