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Basic Training. Collaborative Practice in Long Term Care Setting Jo Ann Fisher, MSN, FNP-C. Basic Training. Objectives. Define the scope of practice of the NP/PA Describe the components of a collaborative agreement

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Basic training
Basic Training

Collaborative Practice in Long Term Care Setting

Jo Ann Fisher, MSN, FNP-C


Basic training1
Basic Training

Objectives

  • Define the scope of practice of the

  • NP/PA

  • Describe the components of a collaborative agreement

  • Describe the NP/PA/Physician duties and responsibilities in a collaborative practice

  • Discuss the clinical privileges and protocols for the nurse practitioner.

  • Describe reimbursement practices


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Basic Training

Definition comes from the Board of Nursing

and the Board of Medicine

Practice is determined by education, level of

experience and state board regulations

Both NPs / PAs must provide their regulatory

boards with required agreements

Define the scope of practice


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Basic Training

Collaborative Agreement

Nurse Practitioners

Protocols: initial, with any change and every 2

years with re-licensure

Includes: requiring authority, parties to the

protocol, nature of practice, description of duties

and management areas (conditions, treatments,

and drug therapies.

Duties of MD/DO and requirements for physician

intervention


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Basic Training

  • Collaborative Agreement

  • Physician Assistants

    • Supervision Data Form sent to the Board

    • of Medicine with original list of

    • supervising physician(s) and location(s)

    • of practice.

    • Lists can be sent if a physician or

    • location is added or deleted

    • No other description of practice needed

.


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Basic Training

Who is Responsible?

  • MD/DO provides clinical as well as

  • practice oversight and education for the

  • NP & PA as needed. Orders need to be

  • co-signed for PAs.

  • NP/PA is responsible for advising the

  • physician of complex or unstable

  • clinical cases, for Schedule 2 drug orders and for advanced directives

  • Both NPs and PAs can practice in LTC and

  • ALF facilities (credentialing is done when

  • requested)


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Basic Training

Payment Issues

  • NPs/PAs both can obtain Medicare,

  • Medicaid, UPIN and NPI numbers

  • Most insurers pay non-physicians

  • Billing can be done by the practice or

  • independently

  • NP/PA can bill for all except the initial

  • H & P, which must be done by MD/DO


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Basic Training

Summary

  • The nurse practitioner and physician

  • assistant offer a high level of care for

  • the LTC patient.

  • Communication between the NP/PA

  • and physician is key to a safe and very

  • beneficial collaborative relationship


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