LTC Laws – PCNP has been working diligently with the Dept of Health to figure out a way to remove the co-signature requirement in long term care (LTC) and skilled nursing facilities (SNF) settings. They partnered with other stakeholders and a proposition had been made to IRRC. The IRRC had their public office meeting and voted unanimously to omit the regulation for the needed co-signature. The changes are now effective as this has been posted in the PA Bulletin effective Oct 2nd.

• This final omitted rule making amends and addresses unnecessarily proscriptive procedures applicable to the provision of care by a CRNP to a resident of a LTC facility. It was found to be unnecessary and broad restriction on CRNP practice and results in a barrier to a nursing home resident’s to qualified health care practitioners and increasing health care costs.

• It was pointed out in the document the term “supervising physician”, the relationship between a CRNP and a physician is one of collaboration.

• Placing specific restrictions on this aspect of the collaborative relationship inhibits the physician and nursing home from fully recognizing the individual CRNP’s training and experience, unnecessarily restricts the physician and nursing home’s utilization of CRNP’s in providing medical care to nursing home residents and ultimately negatively interferes with a nursing home resident’s medical care.

• This includes progress notes, physical exam reports, treatments, medications and other notations made by the CRNP. This document removes the unnecessary restriction of co-signature within 7 day period.