Online Core Curriculum
Includes Multiple Live Events. The next is on 02/10/2026 at 7:00 PM (EST)
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Register
- Non-member - $1,995
- Member - $1,795
The Online Core is part one of the two-part Core Curriculum on Medical Direction in Post-Acute and Long-Term Care (PALTC). The course consists of a series of 30 interactive on-demand modules that provide comprehensive instruction on the medical director role within the PALTC setting. The Online Core also includes live monthly facilitator-led virtual forums, allowing you to discuss the course material in real time with faculty and other participants. Learners can complete the course at their own pace and on their own schedule. Upon completion of the Online Core, participants will be able to effectively fulfill the roles, functions, and tasks of the PALTC medical director.
Learning Objectives
At the completion of this activity, learners should be able to:
- Develop practical skills needed to fulfill the role and responsibilities of the medical director.
- Identify the unique aspects of the PALTC environment that impact the medical director position.
- Describe the organizational responsibilities and dynamics of the medical director and the IDT.
- Develop communication skills to deal with responsibilities for the IDT, residents, and their families.
- Explain the resident care responsibilities of the medical director, including emergency care, quality management, family systems, and ethical considerations.
- Enhance leadership skills and team building towards a stronger role for the medical director with the IDT.
- Develop human resource skills to deal with difficult situations and improve personal effectiveness.
- Improve the medical director’s ability to learn and practice in the evolving health care delivery environment.
- Apply newly acquired knowledge to daily facility and practice activities.
Course Access
Once registered, learners will have access to the course for twelve months after the date of initial registration.
Module
Domain 1: Foundation/Basic Concepts
1 | Course Introduction
Estimated Length: 15 Minutes
Section 1: The Core Curriculum
Section 2: Medical Director Roles, Functions, and Tasks
2 | Overview of Post-Acute and Long-Term Care
Estimated Length: 35 minutes
Section 1: Demographics and History of Long-Term Care Modules
Section 2: Overview of Post-Acute and Long-Term Care Continuum
Section 3: Payors of Post-Acute and Long-Term Care
Section 4: Health Care Industry Trends
3 | Laws and Regulations
Estimated Length: 35 minutes
Section 1: A Brief History: Laws, Regulations, and Federal Government Involvement
Section 2: Overview of Federal Regulations: Intent, Breadth, and Structure
Section 3: How to Find Relevant Regulations
Section 4: Case: Applying Regulations to Everyday Situations
4 | Surveys
Estimated Length: 30 minutes
Section 1: Survey Types and Preparation
Section 2: Onsite Survey Activities
Section 3: What Happens When Deficient Practices Are Identified?
Section 4: What Happens After a Survey?
5 | Responding to Deficiencies
Estimated Length: 30 minutes
Section 1: Plan of Correction
Section 2: Reviewing and Writing Policies
6 | Fundamentals of Nursing Facility Financing
Estimated Length: 50 minutes
Section 1: The Structure of the Nursing Facility Industry
Section 2: Sources of Nursing Facility Revenue
Section 3: PDPM
Section 4: Major Categories of Nursing Facility Expense
7 | Financial Delivery Models and Medical Director Leadership
Estimated Length: 30 minutes
Section 1: The Changing Landscape of Delivery Models and Payments
Section 2: Applying Financial Information in the Role of Nursing Facility Medical Director
8 | Organizational Structure, Culture, and Relationships
Estimated Length: 15 minutes
Section 1: Organizational Structures
Section 2: Organizational Culture
Section 3: Medical Director Role Within an Organization
9 | Resident Rights
Estimated Length: 35 minutes
Section 1: Medical Director Roles and Responsibilities
Section 2: Resident Rights and F-Tags
Section 3: Person-Directed Care
Section 4: Abuse and Neglect
Section 5: Rights Related to Facility Stays
10 | Employee Health and Safety
Estimated Length: 40 minutes
Section 1: Why the Medical Director Should Know About Employee Health
Section 2: Common Nursing Facility Occupational Illnesses
Section 3: Common Nursing Facility Occupational Injuries
Section 4: The Medical Director's Role in Supporting Employee Health and Safety
11 | Medical Director's Agreement and Reporting Responsibilities
Estimated Length: 25 minutes
Section 1: The Medical Director’s Agreement
Section 2: Medical Director Compensation
Section 3: The Medical Director’s Report
12 | Medical Staff Coordination
Estimated Length: 30 minutes
Section 1: Overview of the Medical Director’s Role
Section 2: Medical Care Coordination
Section 3: Tools for Successful Implementation
Domain 2: Processes of Care
13 | Oversight of Provider Documentation
Estimated Length: 35 minutes
Section 1: Provider Documentation
Section 2: Oversight of Provider Documentation
Section 3: Audits
14 | Federal Regulations on Privacy and Documentation
Estimated Length: 25 minutes
Section 1: Federal Regulations on Privacy
Section 2: Example Scenarios for Medical Directors
15 | The Resident Assessment Instrument: Minimum Data Set and Care Area Assessment
Estimated Length: 30 minutes
Section 1: History and Terminology of Resident Assessment
Section 2: The Care Process
Section 3: Workflow of Resident Assessment: Who, What, When, Why, and How
Section 4: Sections of the Minimum Data Set (MDS)
16 | Patient-Centered Care Planning
Estimated Length: 25 minutes
Section 1: Care Area Assessment
Section 2: Patient-Centered Care Planning
17 | Health Care Ethics
Estimated Length: 25 minutes
Section 1: Key Principles of Health Care Ethics
Section 2: Decision-Making Capacity
Section 3: Advance Directives
Section 4: Medical Director Roles and Responsibilities
18 | Working with Families
Estimated Length: 25 minutes
Section 1: Family Dynamics
Section 2: The Family Meeting
Section 3: Communicating Bad News
19 | Medical Direction in Hospice
Estimated Length: 25 minutes
Section 1: Hospice History and Fundamentals
Section 2: Relationship between a Hospice Agency and Nursing Facility
20 | Medical Direction in PACE
Estimated Length: 15 minutes
Section 1: Overview of PACE: History, Enrollment Criteria, and Provision of Services
Section 2: Role of Medical Directors in PACE Programs
21 | Medical Direction in Accountable Care Organizations
Estimated Length: 25 minutes
Section 1: Overview of ACOs
Section 2: Medical Director Opportunities
22 | Medical Direction in Assisted Living
Estimated Length: 25 minutes
Section 1: Assisted Living Overview
Section 2: Levels of Care
Section 3: Medical Direction in Assisted Living
Domain 3: Quality Improvement and Oversight
23 | Quality Management
Estimated Length: 40 minutes
Section 1: Quality: What Does it Mean in the Nursing Facility?
Section 2: Traditional Quality Assurance vs. QAPI
Section 3: QAPI Tools: Understanding Variation
Section 4: QAPI Tools: Implementing PDCA Cycles
Section 5: Regulatory Requirements and Benchmarks for QAPI
Section 6: The Medical Director’s Role
24 | Working Within Nursing Facility Committees and Administrative Structures
Estimated Length: 30 minutes
Section 1: Overview: Role and Value of Committees
Section 2: Important Committees within a Nursing Facility
Section 3: Efficient and Effective Use of Committee Meetings
25 | Infection Prevention and Control
Estimated Length: 45 minutes
Section 1: Introduction to Infections in the PALTC setting
Section 2: The Regulatory Requirements for Infection Control
Section 3: Infection Prevention and Control Program Basics
Section 4: Special Aspects of the Infection Prevention and Control Program
26 | Antibiotic Stewardship and Quality Improvement in IPC
Estimated Length: 45 minutes
Section 1: Antibiotic Stewardship
Section 2: Improving Antibiotic Use
Section 3: Care Transitions and IPC
Section 4: The Role of the Medical Director
Domain 4: Systems Thinking
27 | Risk Management
Estimated Length: 40 minutes
Section 1: Introduction to Risk Management
Section 2: Corporate Compliance
Section 3: Facility Emergency Preparedness
Section 4: Employee Risk Management
Section 5: Medical Director Liability
28 | Transitions of Care
Estimated Length: 25 minutes
Section 1: Why Do Nursing Home Transitions of Care Matter?
Section 2: Barriers to Safe Transitions of Care
Section 3: Improving Transitions of Care
29 | Integration of Systems Theory and Problem-Solving
Estimated Length: 40 minutes
Section 1: Systems
Section 2: Systems Theory
Section 3: Applying Systems Theory to Problem-Solving
30 | Medical Director as Leader
Estimated Length: 45 minutes
Section 1: Defining the Components of Leadership
Section 2: Introduction to Leadership Theories and Styles
Section 3: Assessing Your Leadership Style and Strengths
Section 4: Improving Your Leadership Abilities
Barbara Tommasulo, MD, CMD, LNHA, CWSP
Barbara Tommasulo, MD, CMD, LNHA, CWSP, has devoted her career to caring for older adults, particularly in PALTC. She is certified in internal medicine and geriatric medicine, is a certified wound specialist physician, and is a licensed nursing home administrator in NY. Medical education has been a mainstay throughout Dr. Tommasulo’s career. Her many years of experience in medical direction have included a variety of settings with various medical staff models. Currently, she is the medical director of Northwell Orzac Center for Rehabilitation and assistant professor of medicine at Hofstra North Shore – LIJ School of Medicine.
Jean Storm, DO, CMD
Jean Storm, DO, CMD, is a graduate of the Erie College of Osteopathic Medicine and is Board Certified in internal medicine. She has served as medical director of five long-term care facilities in Erie, PA, and throughout WV. She has also served as the program director for the internal medicine residency program at LECOM Health. She is currently a clinical support physician for Optum/United Healthcare and medical director for a quality improvement organization focused on improving care in long-term care facilities throughout PA and WV. Dr. Storm's interest is in developing policies and strategies that change the way providers view the care delivery process in LTC.
Michael Burke, MD, MBA, CMD
Michael Burke, MD, MBA, CMD, earned his Bachelor of Science degree in biology from Le Moyne College in Syracuse, his Doctor of Medicine degree from SUNY Health Science Center at Stony Brook, and his MBA at University of Massachusetts, Boston. He completed his Internal Medicine residency at the Mary Imogene Bassett Hospital in Cooperstown, New York, and his Geriatric fellowship from the Harvard Division on Aging at the Beth Israel Deaconess Medical Center in Boston. Dr. Burke is certified in Geriatric Medicine, Hospice and Palliative Medicine by the American Board of Internal Medicine. He is also a member of the American Geriatric Society, American Medical Directors Association, and the American Academy of Hospice and Palliative Medicine. Dr. Burke will be joining the Continuing Care Division with the goal of continuing to improve the health of our communities and the older adults we serve.
Rebecca Ferrini, MD, MPH, CMD
Rebecca Ferrini, MD, MPH, CMD, is a full-time medical director for the County of San Diego 192-bed distinct part skilled nursing facility serving a younger, safety net population for 18 years. Her facility is five stars (CMS 20/20), has been named a top nursing home in U.S. News and World Report for six years, and received the American Health Care Association / National Center for Assisted Living 2017 Gold -- Excellence in Quality Award. Dr. Ferrini received the 2009 AMDA Medical Director of the Year Award and was honored for her leadership in the AMDA monograph on younger adults. Dr. Ferrini received the California Association of Long-Term Care Medicine Leadership Award in 2019. She has a specialty in hospice and palliative medicine and general preventive medicine.
John Heath MD, CMD
John Heath MD, CMD, completed his geriatric medicine fellowship at the University of Cincinnati in 1988 and has since been medical director for various PALTC facilities, including experience as a multi-facility corporate medical director. Currently medical director at the Hunterdon Care Center in Flemington, NJ, Dr. Heath joined the Hackensack Meridian Health System in 2021. Previously, Dr. Heath was a professor and geriatric medicine fellowship director at the Robert Wood Johnson Medical School and then established the Geriatric Services department for the Summit Medical Group. He is a fellow of the American Academy of Family Physicians and the American Geriatric Society, and a past board member of the New Jersey Geriatric Society.
Nancy Istenes, DO, CMD, FACP
Nancy Istenes, DO, CMD, FACP, has over 25 years of experience working in geriatric medicine and long-term care. Currently, she is the Chief Medical Officer for Saber Healthcare Group. She prides herself on working with all levels of the company and bridging the gaps between executive leadership, facility, and regional teams, providers, vendors, pharmacy, and other key industry participants. Her teamwork and approachability have helped lead the company to improve resident care and clinical outcomes. She has been a certified medical director for more than 20 years and an active member of PALTmed for her entire career, where she has provided leadership at both the state and national levels.
Cynthia Kuttner, MD, CMD
Cynthia Kuttner, MD, CMD, is the medical director of the Community Living Center at the Wilmington VA Medical Center in Wilmington, Delaware. She is also an adjunct assistant professor of Geriatrics and Gerontology at the Rowan-Virtua School of Osteopathic Medicine. She is a graduate of the Mount Sinai School of Medicine in New York City and completed a primary care Internal Medicine residency at Montefiore Hospital in the Bronx, New York. She is fellowship-trained in Geriatrics at the Johns Hopkins Bayview Medical Center in Baltimore, Maryland. Prior to joining the Veterans Administration, she served as the medical director at several community nursing homes in Ohio.
Lee Lindquist, MD, MPH, MBA, CMD
Lee Lindquist, MD, MPH, MBA, CMD, is chief of geriatrics at Northwestern University Feinberg School of Medicine, Chicago, IL. She is medical director and sees patients at the Clare, a 55-story, five-star CMS, continuing care retirement community in downtown Chicago. Dr. Linquist is federally funded by PCORI, NIH, AHRQ, and CMS, and her research focuses on long-term care decision-making.
Thomas Lawrence, MD, CMD
Thomas Lawrence, MD, CMD, is a geriatric medicine specialist with a career focus on practicing in the long-term care setting. He is Board Certified in Internal Medicine and Geriatric Medicine and has served as medical director of 12 nursing facilities in Pennsylvania. Dr. Lawrence is currently the system medical director of geriatric medicine and long-term care for the Main Line Health System, a four-hospital health system in suburban Philadelphia. Dr. Lawrence is a past president of the Pennsylvania Society for Post-Acute and Long-Term Care Medicine and is a member of the Board of the American Board of Post-Acute and Long-Term Care Medicine.
Dheeraj Mahajan, MD, MBA, MPH, FACP, CMD, CHCQM, CIC
Dheeraj Mahajan, MD, MBA, MPH, FACP, CMD, CHCQM, CIC, is president and CEO of Chicago Internal Medicine Practice and Research and its associated group of companies and clinical associate professor of medicine at the University of Illinois at Chicago. He is a fellow of the American College of Physicians and board-certified in Internal Medicine and Geriatric Medicine. Additionally, Dr. Mahajan is a certified medical director, a certified physician advisor in utilization review and healthcare quality management, and is certified in infection control and epidemiology.
Michael Nash, MD, CMD
Michael Nash, MD, CMD, is a board-certified family medicine practicing primarily in the post-acute and long-term care setting since 2011. He has served as medical director at many skilled nursing and assisted living facilities, mostly in the St. Louis, Missouri area, and has served as a physician leader for post-acute provider groups. Dr. Nash has been the president of the Missouri Association of Long-Term Care Physicians (now PALTMed Midwest) since 2022, and is an active member of the Post-Acute and Long-Term Care Medical Association since 2017. He has served on the PALTMed Assisted Living Subcomittee, the Clinical Practice Committee, and given presentations at two PALTMed national meetings. Dr. Nash has given numerous lectures on medical direction in nursing homes and clinical practice in post-acute and long-term care throughout the midwest.
Meenakshi Patel, MD, MMM, CMD
Meenakshi Patel, MD, MMM, CMD, is a clinical associate professor at Wright State University in Dayton, Ohio, and Ohio Heritage University of Osteopathic Medicine in Athens, OH. She is also a practicing physician at Valley Medical Primary Care, a principal investigator at Valley Medical Research, and a medical director at several nursing homes. She teaches internal medicine and geriatrics to medical students, internal medicine and family medicine residents, and geriatric fellows. She has been very active with AMDA-The Society in several roles, including as a board member, member of multiple committees, and writing clinical practice guidelines on the management of diabetes in the long-term care setting. Dr. Patel has served as president of the Ohio Medical Directors Association.
Luz Ramos-Bonner, MD, MBA, CMD
Luz Ramos-Bonner, MD, MBA, CMD, is part of Independence Family of Companies as a network medical director for Independence Blue Cross. In this role, Dr. Ramos is responsible for collaborating with primary care providers to drive improved performance in the Pennsylvania market, including primary care population health and value-based programs with health systems. As part of the clinical care transformation leadership, her cross-functional role includes initiatives that promote whole-person equitable health and advancing the quintiple aim. Dr. Ramos is a geriatrician and finished her Masters of Business Administration in Healthcare at the George Washington University.
Ronald Rosen, MD, CMD
Ronald Rosen, MD, CMD, is a board-certified family physician with over forty years of clinical and leadership experience in geriatrics, hospice, and palliative medicine. He holds certificates of added qualification in both Geriatrics and Hospice and Palliative Medicine and has expertise in post-acute and long-term care, advanced illness management, and interdisciplinary team leadership. He maintains a special interest in medical legal issues and skin failure, with recent scholarly and clinical work focused on diagnostic precision and diabetes management. Dr. Rosen is committed to improving care for aging populations through innovation, collaboration, and education, and has contributed to professional associations, publications, and national conferences.
Toby Smith, DO, CMD
Toby Smith, DO, CMD, is a current practicing geriatrician and medical director in Hawaii. He serves in multiple roles for nursing facilities, hospice organizations, and insurers throughout the state of Hawaii. He has provided expertise in his role as chief medical officer and vice president for provider groups and is the current vice president of the Hawaii chapter of AMDA - The Society for Post-Acute and Long-Term Care Medicine. He earned his doctorate degree in osteopathic medicine from Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, and has a Master of Science degree in Kinesiology from California State University Northridge. Dr. Smith did his internship and residency at the University of Hawaii and is board-certified in internal medicine, geriatric medicine, and hospice & palliative medicine. Dr. Smith is an assistant professor at the University of Hawaii’s Department of Geriatric Medicine.
Todd Sobol, MD, CMD
Todd Sobol, MD, CMD, has 26 years of private practice experience as a general internist specializing in geriatric medicine. During his tenure, he served as a medical director in long-term care facilities, assisted living, managed care, and hospice. Dr. Sobol served as an enthusiastic educator for students and residents, including recognition as a Preceptor All Star by The Ohio State University College of Medicine. He has supported the Ohio Medical Directors Association as Program Chairman for their annual conference, Board of Directors member, and President. Dr. Sobol is currently senior medical director for Optum Complex Population Management in Ohio.
Richard Stefanacci, DO, MBA, CMD
Richard Stefanacci, DO, MGH, MBA, AGSF, CMD, a practicing internist/geriatrician, has a long-standing interest in and commitment to the frail elderly as his clinical practice solely focuses on nursing home eligible older adults through the PACE program (Program for All-inclusive Care for the Elderly). He is currently engaged with a large health system in developing a preferred skilled nursing home network of providers. He also continues medical direction for managed care plans, especially involved in medication management. He received his BA in economics at Boston College, his medical degree and MGH from AT Still University, and his MBA from Keller. In addition, Dr. Stefanacci is a fellow of the American Geriatric Society and College of Physicians of Philadelphia.
Matthew Wayne, MD, CMD
Matthew Wayne, MD, CMD, is an experienced chief medical officer with a demonstrated history of working in the hospital and health care industry. He is currently chief medical officer for CommuniCare Family of Companies and CEO of Personalized Health Partners. He has skills in population health, disease management, Medicare and Medicaid, and physician relations. He is a long-time active AMDA member and served as president in 2012-2103.
Glen Xiong, MD, CMD
Glen Xiong, MD, CMD, earned his medical degree (MD) from the University of California at Davis and completed his residency training in Internal Medicine and Psychiatry at Duke. He practices in subacute settings (SNFs) and chronic psychosis (Mental Health Rehabilitation and Special Treatment Programs [STPs]). He teaches students, residents, and fellows as part of their geriatric medicine rotations in skilled nursing facilities. He has published in the areas of medication safety, dementia care, and telemedicine.
- 17.5 CME
- 17.5 CMD Management
- 17.5 MOC
Release Date: 01/02/2024 | Expiration: 12/31/2026
Credit Statements
Accreditation: Post-Acute and Long-Term Care Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
CME Designation: Post-Acute and Long-Term Care Medical Association designates this enduring material for a maximum of 17.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CMD Credit Hours: This CME activity has been pre-approved for up to 17.5 management hour(s) toward certification or recertification as a Certified Medical Director (CMD) in post-acute and long-term care medicine. Each physician should claim only those hours of credit actually spent on the activity. The CMD Program is administered by PALTmed. For further information, contact PALTmed at 410-992-3115 or at certification@paltmed.org.
ABIM MOC: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 17.5 Medical Knowledge MOC points and patient safety MOC credit in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
Financial Disclosure Statement
The following faculty and/or planners disclosed a relevant financial relationship:
- Luz Ramos-Bonner, MD, MBA, CMD - Stock Shareholder: InnovAge; Fulltime/Parttime Employee: Independence Blue Cross
- Meenakshi Patel, MD, CMD – Speakers Bureau: Viatris, Teva and Otsuka/Lundbeck; Grant Research: Janssen, Eli Lilly, GSK, LMT, Acadia, Annovis
- Todd Sobol, MD, CMD – Advisory Board: CareBand Inc.
- Richard Stefanacci, DO, MBA, CMD - Consultant: Active Protective (TangoBelt)
- Michael Wasserman, MD, CMD – Advisory Board: Merck Manual; Stock Shareholder: Sanolla
- Glen Xiong, MD, CMD - Advisory Board: Blue Cross Blue Shield Federal Employee Program Medical Policy and Therapeutics Committee; Consultant: iTreat, Asynch Health; Honoraria: Wolter Kluwers, American Psychiatric Publishing Inc; Stock Shareholder: SafelyYou
All relevant relationships have been mitigated by the Association. No one else in control of content disclosed any relevant financial relationships with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Faculty Forums offer an opportunity to discuss course material in real-time with course faculty and peers, and how it applies to situations medical directors face daily. Virtual forums are held monthly on Tuesdays from 7:00-8:00 PM ET.
Discussion topics include regulations, infection prevention and control, leadership, transitions of care, and working with families. Participants can ask questions during the live forum or submit questions beforehand.
Participation in one Faculty Forum is required to complete the Online Core. You will have access to the Faculty Forums for up to six months from your course registration date. Participants are encouraged to attend multiple faculty forums during the access period.
Completing the Online Core and at least one Faculty Forum is a prerequisite for participating in the Core Synthesis weekend. Participants access the live Faculty Forums through the Online Core course.
Course Pricing
| Member Price | Non-Member Price | |
| Physician | $1,795 | $1,995 |
| NP/PA/Student | $995 | $1,195 |
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Once registered, participants will have access to the course for up to 6 months after the date of initial course registration.
Online Core Curriculum Refund Policy
Refunds are available under the following conditions and rates:
- A refund of the full registration fee if the request is sent to registration@paltmed.org within 7 calendar days of registration and no progress has been made in the course.
- A refund of 50% of the registration fee less a $100 administrative fee if the request is received by registration@paltmed.org within 30 calendar days of registration and no more than 50% progress has been made in the course.
- No refund is available if 80% of the course has been completed.
- No refunds will be granted after 30 calendar days of registration.
- No refunds will be granted for individuals who claim continuing education credits or do not complete the course modules within the 6-month period given.
- No refunds will be granted to individuals who experience technical difficulties. If you have questions about the system requirements to participate in this online education program or the refund policy, contact the Education Department at education@paltmed.org or 410-992-3122.
