HB 2640 establishes new certification and training requirements for medical directors at certain nursing facilities. Medical directors must obtain certification from the Post-Acute and Long-Term Care Medical Association (or an equivalent certification approved by the state) and complete a state-developed training course covering compliance, quality improvement, infection control, and resident care management. However, facilities in medically underserved rural areas may be exempt if they demonstrate a good faith effort but are unable to recruit a certified medical director. The new requirements apply to medical directors hired on or after March 1, 2026.