This week’s Ftag of the Week is part of the Physician Services regulatory group. The regulation requires that a physician must personally approve in writing a recommendation that a person be admitted to a facility. A non-physician practitioner (Nurse Practitioner, Clinical Nurse Specialist and Physician Assistant) is not allowed to provide this written recommendation.
This physician written recommendation can happen in a number of ways, including:
- A hospital transfer summary
- Paperwork completed by the resident’s physician in the community, or
- Another written form by a physician.
If a physician recommendation is not provided prior to an admission, the physician’s admission orders for immediate care of the resident will be accepted as, per regulation, “personal approval” of the physician recommendation for admission. It is very clear that a non-physician practitioner cannot provide this written recommendation, as the regulation assigns this task to be “personally” completed by the physician.
The regulation is also clear that every resident must be under the care of a physician while at the facility, and that orders for a resident’s immediate care and needs must be provided by a physician, physician assistant, nurse practitioner or a clinical nurse specialist.
Remember, that there is physician responsibility for supervising the care and participating in resident assessment and resident-centered care planning, monitoring and addressing change in medical status, writing medication and treatment orders, as well as responding when contacted by the facility. The physician is responsible for conducting routine visits, but if he/she delegates follow-up visits to an non-physician practitioner the physician’s supervision responsibilities remain.
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