Skilled nursing operators now have greater flexibility in allowing non-physicians to do certain tasks. The Centers for Medicare & Medicaid Services clarified what may be delegated in an April 3 brief.
Physicians can off-load tasks to a non-physician practitioner, such as a nurse practitioner, physician assistant or clinical nurse specialist.
However, a physician still must conduct an initial comprehensive visit within 30 days of a resident being admitted to a skilled nursing facility. But a non-physician practitioner may visit patients before and after the initial physician visit when deemed medically necessary.
The CMS document notes a facility employee still can’t sign a certification or recertification of a resident’s need for skilled care. However, if allowed by the state, non-physician practitioners who are not employed by the facility are allowed to sign these documents.
In facilities where beds are certified under both Medicare and Medicaid, regulations are determined according to which program is paying for the resident’s care, according to CMS. For example, in the case of a dual-eligible whose stay is paid through Medicaid, any required physician task can be performed by a NPP who is not employed by the facility, subject to state regulations.
“Improper application of these regulations may affect a facility’s compliance and payment,” CMS said.
From the May 01, 2013 Issue of McKnight's Long-Term Care News
