The preliminary impact of Maryland's medical director and attending physician regulations.

OBJECTIVES To identify the impact of the regulations implemented in Maryland in 2001, related to nursing home attending physicians and medical directors, and nursing home quality assurance requirements, on Maryland nursing homes, administrators, and physicians. DESIGN Two surveys were mailed to all nursing home administrators in Maryland, one for their completion and one to give to their medical directors to complete. These surveys were to be returned by mail to the authors. SETTING All nursing homes in all jurisdictions in Maryland. PARTICIPANTS Two-fifths of administrators and medical directors in Maryland nursing homes completed and returned the survey. MEASUREMENTS Results were tabulated for each question of each survey, and were calculated as percentages of the total responses. Additionally, individual comments were reviewed. RESULTS A relatively large sample of administrators and medical directors in Maryland responded. Most respondents were positive or at least neutral about the impact of these regulations on them and their organizations. Many administrators agreed that there had been improvements in medical director participation and performance. There were significant advances in medical director compensation. There were relatively few negative comments about the impact. CONCLUSION Requirements for physician and medical director accountability appear to have had a positive impact on medical director performance and relationships with nursing home administrators. Additional study is warranted to measure the impact of that performance on patient care outcomes and facility performance.