Florida regulators are moving to strengthen oversight of nursing home leadership by tightening the requirements for medical directors across the state.
On Feb. 12, 2026, the Florida Agency for Health Care Administration (AHCA) proposed amendments to two sections of the Florida Administrative Code — Rules 59A-4.107 and 59A-4.0175 — to align state regulations with legislative changes adopted for the 2025–2026 fiscal year. The revisions would apply retroactively to Jan. 1, 2026.
New Certification Standards Take Shape
Under existing law, every Florida nursing home must appoint a Florida-licensed physician as its medical director. That physician is responsible for participating in resident care planning and serving on the facility’s risk management and quality assurance committee.
Historically, the state required little beyond an active medical license and hospital-admitting privileges — or equivalent national credentials. However, lawmakers amended Section 400.141 of Florida Statutes as part of broader nursing home governance reforms last year.
The proposed rule now requires medical directors to hold an active certification as a medical director or to be actively pursuing one. Regulators define “in the process” as enrollment and participation in a recognized certification program, including the Core Curriculum on Medical Direction in Post-Acute and Long-Term Care offered by the Post-Acute and Long-Term Care Medical Association (PALTmed) or another AHCA-approved program focused on clinical and management training.
Timeline for Compliance
Certification through PALTmed — known as Certified Medical Director (CMD) — can take up to a year to complete. The credential is valid for six years and requires 120 continuing medical education credits, split evenly between clinical and management topics.
Medical directors appointed before Jan. 1, 2026, would have until Dec. 31, 2028, to obtain or renew certification. Those appointed on or after Jan. 1, 2026, would have three years from their start date to comply.
Nursing homes would also be required to submit documentation of their medical director’s certification status as part of initial licensure, renewal, change of ownership, or when appointing a new director.
AHCA will accept public comments on the proposal through March 5, 2026.
