The nursing facility shall: Be responsible for working with the medical director to ensure adequate resident care and practitioner performance; Inform the physician of explicit requirements as a medical director and assist the medical director in gaining the necessary information and tools to properly execute those responsibilities; and Ensure that the medical director has the necessary support and authority to perform medical director duties effectively and to hold practitioners accountable. When the attending physician and medical director document a resident’s medical need for a particular treatment, assistive device, or equipment, the nursing home shall provide that treatment, assistive device, or equipment unless the nursing home documents in the quality assurance committee minutes the reason or reasons why the treatment, assistive device, or equipment should not be provided. When the attending physician and medical director agree that a particular nursing home developed protocol is required to ensure that quality medical care is delivered to the nursing home’s residents, that protocol shall be implemented unless the nursing home documents in the nursing home’s resident care committee minutes the reason or reasons why the protocol should not be implemented. Evaluation of Medical Director's Performance. The facility shall have a mechanism for evaluating the medical director's performance and for providing the medical director with feedback about that performance. The criteria for evaluation shall be based on explicit medical director responsibilities and shall facilitate the medical director's improvement and performance of functions and duties.