Editor's Note: This is Part One of two articles looking at the role of nurse practitioners in long-term care.
More long-term care and skilled nursing facilities are assuming care for the elderly. These facilities feel the brunt of a changing America and a healthcare crisis. That's why Medicare should mandate the use of third-party nurse practitioners in long-term care and SNFs. Long-term care and skilled nursing facilities would greatly benefit from this.
Third-party nurse practitioners have permission to see patients, but work for another company whose sole purpose is to offer their services to LTC and SNFs. The scope of practice of NPs enable them to order labs and write prescriptions. The nurse practitioner scope of practice is nearly identical to physicians; in fact they can do 80% to 85% of a physician's scope of practice, with only a few exceptions including initial visits, and provisions under title 22.
Having a full time nurse practitioner in LTC facilities would help take the load of the facility staff. Hiring a nurse practitioner independently is not feasible for many LTC and SNF's, and the money to pay them is just not accessible. Unlike a “facility hired” nurse practitioner, third party nurse practitioners can independently bill Medicare and other insurance providers. The Balanced Budget Act of 1997 authorized NPs and CNSs to bill Medicare directly for their services.
While some facilities are weary of the concept of nurse practitioners because of their cost, preventive medicine has proven time and time again to be more cost effective in the long-term. Since nurse practitioners can see any patient with a change in health, he or she can avoid costly and unnecessary patient transfers, and give the patient needed care in a timely manner. Just the absence of lag time between a patient need and care delivery can help a facility greatly during state and federal surveys, not to mention the added professional guidance most facilities need.
Sarah Stephens is the Director of Operations at Mobile Medical Nursing Inc, which specializes in the management of long- term care patients by a professional staff of nurse practitioners.