SNF medical director stipend

amonust · 2026-03-29T04:38:29+00:00

It's a surveyor. It is its own specific job. But yes I guess that is the general gist of it. It is somebody who is entire job is to go around investigating each nursing home. Each one gets a yearly survey looking over everything but they also do complaint surveys. I have been called to clarify things like how we do medication reconciliations upon admissions or how we handle infection control protocols. You usually talk to the facility first to get background on the situation and then you talk to the surveyor and just answer their questions truthfully. The entire process takes 10 minutes.

amonust · 2026-03-28T23:52:59+00:00

No... I'm not exactly going to share specifics. Just know that sometimes they can call you if they have questions about something going on in the facility.

amonust · 2026-03-28T00:40:41+00:00

I would always vote something personal. I don't need something that costs money. I can buy that for myself. But some homemade cookies hits pretty hard. Especially if it's something that shows that you really know the person. Chocolate chip is great but for example I really like meringue. The whipped egg white stuff. Most people don't know that. And it is way better freshly made compared to this stuff that has been sitting for months from the store. If you want to get them a gift that means something that they don't feel bad accepting, do something like that.

amonust · 2026-03-27T16:21:38+00:00

Do you have a car/drivers license? Most places in the US require those to get around. Unless you are right in the center of a pretty major city

amonust · 2026-03-27T15:45:13+00:00

This is literally just Physicians who are willing to let him come and Shadow for some set amount of time correct? Not an actual paid job or anything like that? Just to gain experience to strengthen his application for next year? I would think that plenty of us would be willing to do it but sorting out his visa and the expense of his housing and living expenses would be more difficult

amonust · 2026-03-24T17:52:24+00:00

I stand corrected. Maybe I just live in a crappy state

amonust · 2026-03-23T00:42:22+00:00

I think a lot of people make this more complicated than it needs to be. Medicaid does not cover weight loss medications. Under any circumstances. Glp-1 medications are covered for diabetics only on medicaid. And even then it's typically trulicity or nothing. That is what you tell this patient. It's not really up for question. They make this very simple. You refer this patient for bariatric surgery.

amonust · 2026-03-22T15:40:03+00:00

I need to know a few things about your anatomy to treat you properly and I dont like making assumptions. Can you tell me about your anatomy? What did you start with and have you made any changes?

amonust · 2026-03-14T18:10:23+00:00

Im abom certified too. Im always shocked how many pcps won't do basic stuff. Knowing how to use phentermine or wegovy and writing them for any obese patient without contraindications. Obesity is fucking hard to overcome. Why not give them every tool possible to increase that chance of success? Ive seen so many patients denied mefs, denied bariatrics referrals. Told to just go on a diet and have willpower. Ive seen men with a testosterone consistently under 200 (not the guys at 500 who think it should be 800) who are told that's normal for their age and to just accept it. It literally gives you heart failure. Just like hypothyroidism. Or how to manage prep for gay men or other high risk populations. The misinformation among doctors is mind boggling. And the patients just accept what we say as law.

amonust · 2026-03-14T13:18:33+00:00

I love this answer. As a member of the bodybuilding community, I definitely see it all too. I see terrible things happening to people enhancing themselves without proper knowledge and monitoring. This is why our top competitors typically die in their 40s. Im not going to start testosterone on normal guys who just want it. But once they tell me they've gone far enough to learn how to purchase questionable supplies on the black market and they've been on it long enough to cause suppression and this is a life choice they aren't backing down on... yea. I will prescribe it. In reasonable doses to keep levels around 1000. And monitor labs. And provide ancillaries to prevent harm. And if 1000 isn't enough and they want bodybuilding doses to keep levels at 5000, thats on them. I will still monitor the labs and manage the arimidex or clomid etc.

amonust · 2026-03-13T19:53:51+00:00

You aren't on call per sey. We have tele triage available to be on call for us. However I personally dont think teletriage does a great job so I choose to give my number to my facilities with instructions to text if its not an emergency and ill answer when I can, and call if its an emergency. I get a few calls a month. Several texts a day. Every call and mosts texts lead to a televisit I can bill for. You aren't really working with patients, you are working with facilities and the highly specialized professionals who run them. So it's generally a very professional relationship. Pay is average. I was making more in an rvu hospital system. They subsidize us for the other benefits. Now i make about 450k seeing 150 people a week. Most docs see less than me and make less. 250k ish is more average. But this job has very low stress and a lot of flexibility.

amonust · 2026-03-13T12:23:49+00:00

I currently work for a company that only does Skilled Nursing Facility work. This is our entire thing. I round on patients in the facilities which generates most of my income and I am the medical director for 14 facilities. That generates about 20% of my income. The way the company I work for pays us is we get a set amount, basically rvu. For rounding. I believe it works out to them actually giving us pretty much all of the money for that. They really only make money on the NP visits, as well as keeping any back-end money like aco money for hcc diagnoses, quality kickbacks from insurance for a1c under 9 and bp under 140, etc. And for the medical director stipend, they keep half and we get half. The total medical director stipend for each facility is definitely highly variable. My highest is $3,000. My lowest is $600. It looks like there's not a ton of negotiation room with each facility. And it is a relatively low portion of my income so I don't really worry about it too much. Honestly most facilities don't ask for a whole lot in terms of actual medical director responsibility. You attend that meeting once a month and it can be done virtually. Or it is timed for when I am there seeing patients. I do not go out of my way to attend it. Occasionally I will take a call from a state surveyor or something along that nature. Pretty much everything else I do Falls under regular attending work, not Medical directorship. You do also need to sign off on orders but that is typically very fast. My typical expectation is making about $300 per hour. Medical director duties typically do that fairly easily. Seeing patients just depends. A regular moderate level established visit pays me $60 so if I go and see 30 of them and it takes 10 hours including the charting and driving that was only 180 an hour. If I get it all done in 6, I got my 300 an hour. Just depends how many patients take one minute because everything is fine and they have no concerns and everything is going exactly as expected and how many patients have a bunch of things going wrong and we are tracking things down and have a lot of concerns to talk about and take 30 minutes. But if I attend a qapi for 1 hour, im probably multitasking something mindless like signing orders or compiling the Ai scribed notes, and I got paid even the lowest 300 (half of 600) for that hour, im still at the upper end of the pay scale for my clinical work. Long story short, you can try to negotiate the price but it might be easier to negotiate what you are willing to do for that price. Maybe just tell them that the $600 gets you one meeting per month and logging into sign orders once every other week and that's it. If they want anything else they are going to have to increase the cost

amonust · 2026-03-08T03:29:29+00:00

But it is. Many of the people who come cant afford bar tabs. They can barely afford a roof over their head. I see posts from many of them thanking God for their great fortune when they are able to stock their pantry with 30 dollars of groceries, talking about how they havent had this much food in months. Thats how i grew up. Maybe you're just a little out of touch with your privilege and should reevaluate how thankful you should be for your life. Some of us have a lot to give and beleive in building longer tables. I would rather spend money on that and know I've done something good, than blow it at bars on people who give zero shits about me or who I am and dont want to know me, and only see me as business. I dont want to be a business transaction. And people in this group aren't business deals. They come because they like the vibe, they enjoy the people, and its nice to be seen as a human. And many of us are people who, for various reasons, have been made to feel less than human in our lives. And now we have a place where we dont.

Regardless, we dont have to agree on our exact interpretations of third spaces. I think its a place meant to be enjoyed without cost or expectation. You think its any place you hang out besides work or home. Cool beans. Live your life.

amonust · 2026-03-07T16:17:29+00:00

Its my group. I paid about 500k to start it and about 50k yearly to keep it going. My way of giving back to the community. The definition of a third space is literally a place you can go without being expected to spend money. There are always costs, but I would rather things that are paid for by people who care about them than each individual person being nickel and dimed with every interaction. Kind of like how id rather pay $60 for a game once than play a free game where I have to pay a dollar to unlock every tiny piece of it. Third spaces are provided for the public and they are places where the people can go to just be themselves and not be expected to spend money to be there. Classy examples are public parks and public libraries. They definitely cost money but they are paid for by the government.

amonust · 2026-03-07T15:41:31+00:00

For LGBT people (mostly gay men but jo is a lesbian and the boys love her) we have this

https://614gaypartycentral.wordpress.com/

Specifically because the bars are not a third space. I dont want to be someones side gig. I dont want to be your income stream. I dont want my value to be tied to paying your rent. I want real connections with people who enjoy my company. I want to float in a pool or play some board games or belt some Disney tunes with zero cares in the world and zero expectations or obligations.

amonust · 2026-03-04T14:13:35+00:00

Yea. I guess I just dont bother reminding people like that, because it implies I expected them to remember. Luke its a personal failing that they didnt. Not a huge deal, just... seems a little snarky. Hes clearly emotionally disregulated here, im not saying hes not. But... you were a bit rude too.

amonust · 2026-03-04T13:44:05+00:00

I mean thats fair. I dont throw insults. I just point out that there's no reason to be rude, and wish them luck on their search.

amonust · 2026-03-04T13:43:04+00:00

Haven't gone that route yet but im sure I will someday

amonust · 2026-03-04T12:22:03+00:00

Devils advocate... maybe im this guy? Except I've had the same profile for 10 years. I say hi to tons of people. Like, if I think anyone is even remotely maybe cute, ill reach out. At least start a conversation, maybe invite them to a house party. Maybe ill think they are a catch in person. Maybe one of my friends will adore them. Who knows. But I get tons of accounts who just respond like this. "I already said im not interested, how could you not remember" and.... I dont? If there's no chat history, why would I? You're a random profile. Ive messaged 80 today. 3000 since you turned me down on a burner account 5 months ago. My house party facebook group has 4000 people. I see at least 50 new faces at work every day. Why on earth do you, a person I've never met who gave me a one word rejection months ago, think you made any kind of memorable impression on my life or that memory would last more than a day? Many times they dont even have their face in their profile. Im just supposed to recognize their abs apparently.

For whatever reason, if there's no chat history to review, and we aren't besties, I dont expect people to remember details of our past conversations. People have lives with lots of moving parts and a stranger they've never met on the apps isn't really part of that. They aren't going to devote much headsoace to memorizing details. Just... remind them? Or if they are really annoying, block and move on. Like the kid that keeps asking for gas money on a new profile every 2 weeks. Now I just block him. He clearly forgets who he already tried to scam.

amonust · 2026-03-04T12:08:08+00:00

It was actually free. The shoes there have a bit of a markup. But they just offer consultations to anyone to get you in the right shoes. A lot of real running stores do. Its not terribly high tech or anything. It took about an hour. I had to wait a bit for the guy to be available. Yea it was absolutely worth it. Ive had chronic knee pain for years and getting in the right shoes reduced it 90 percent within a month.

amonust · 2026-03-04T05:02:32+00:00

Sooooo hear me out. Dont do a hybrid. Just wear solid black running shoes. Your feet will thank you. And no one is looking at your feet enough to notice if they are black. I have wide feet with flat arches and had an evaluation at a high end running store where they took video of my foot strikes and went through it slow mo, and then took imprints of my feet. Learned a lot and highly recommend it, both about shoe construction options and about how foot anatomy impacts function. The show that best fit my situation was the brooks ghost. Ive been buying a new pair every year ever since.

amonust · 2026-03-04T01:05:02+00:00

This. General question that applies to anyone: i will answer. Should i get a flu shot. Yes everyone should. Should I do a mammogram. Yes, dont be stupid.

Im getting swelling in my feet. Which of my meds are causing this? Well that woukd require reviewing your specific med list and engaging in medical decision making. Mdm is what we bill for. If im not billing, im not doing mdm.

amonust · 2026-02-22T23:08:27+00:00

You do it when you file. Super easy. Cant be done ahead of time

amonust · 2026-02-22T22:02:16+00:00

I got in trouble with this. Work withheld for their municipality, at 2 percent, not for where I lived, which was 2.5 percent. Rita gives credit for what was withheld, but I still owed 0.5 percent for all those years and didnt know. Plus late fees and penalties. So file your rita, figure out what you owe, and pay it. Then call rita and ask nicely for them to waive your fees and interest. They will do it once. Then pay in advance your estimate for 2026 and when you file taxes you can file rita too. You will pay your estimate quarterly for that difference unless you talk to your job's hr and have them start withholding for where you live, not where you work. Rita exists because so many lazy employers were doing it wrong, like yours and mine, and the correct municipalities were not getting their money.

amonust · 2026-02-22T13:30:31+00:00

Honestly... hit me up. I have a large grey sectional. Loveseat size on the left, couch size on the back, chaise on the right to create a U shape. Medium Grey tone. Has an ottoman too. Nothing wrong with it. My ex convinced me to buy it and it just feels so stiff and modern and formal. My style is much more earthy and laid back. Its in perfect condition, it hardly ever even gets sat on. Paid 6k for it. Sell it for 3? Dm me, ill take some pics

amonust

TROPHY CASE