Legal/Professional Issues for Advanced Practice Nurses

 
 
  • Can an NP Act as an Attending at a Nonskilled Nursing Facility? Can an NP act as an attending at a nonskilled nursing facility in Illinois or in other states?
  • What Is the Legal Definition of "For Cause"? I am an APN working in an employee health office. I was asked to perform a "for cause" breath test on an employee. What is the legal definition of "for cause"?
  • APN and Collaborative Agreements I see patients of many different physician/surgeons. Am I required to have a collaborative agreement with all of the surgeons whose patients I follow/treat?
  • NPs Acting as "Attendings" for Hospice Patients Are there state regulations that would prohibit NPs from being the attending for hospice patients on Medicare or Medicaid? Are NP attendings reimbursed equally to the MD?
  • Are There Drawbacks to an NP Providing Spa Services? I am an ANCC-certified APN and I am providing anti-aging/cosmetic services in a medical spa. Will this ultimately jeopardize my credentialing as a "family" nurse practitioner?
  • Who Can Legally Dispense Drug Samples? Who can legally dispense drugs from the sample closet? Can licensed practical nurses (LPNs), medical assistants (MAs), and registered nurses (RNs) do this?
  • Does a Physician Need to Sign All NP Charts? Does my supervising MD need to review and sign off on every one of my charts? My nurse practice act in Georgia is vague with regard to supervision/collaboration issues.
  • Average Caseload for an NP in Long-term Care Can you describe what an average caseload is for an NP in the long-term care setting? What variables should I consider when determining an appropriate caseload?
  • Noncompliant Patient How can I protect myself from a noncompliant patient who decides to sue because of a poor outcome related to his/her noncompliance? Carolyn Buppert offers guidance.
  • NP Orders at a Home Health Agency Versus a Hospice Despite the fact that I can act and bill as an attending for my patients, I am told by VNA hospice that I cannot sign my own orders. Is it true that only physicians can sign the orders?
  • Flexibility in NP Work Schedule I need more flexibility in deciding my NP work schedule. Is there anything that would provide that flexibility while also using my NP experience and training?
  • Reentering the Workforce as an FNP I am a family nurse practitioner (FNP) who graduated in August 2002. I have not practiced as an FNP anywhere since that time. What steps do you recommend I take to reenter the workforce?
  • Keeping My Own Patient Visit Records An NP asks: Do I have a legal right to see my patient visits as tracked by the practice's billing company or office? Are there legal issues related to photocopying charge slips for my own records?
  • Nurse Practitioner Job Description I recently joined a 10-physician cardiology practice as the first NP. I would like suggestions on a job description. The partners seem to each have a different idea of how to work with me.
  • Percentage–Based Salaries My employer is considering changing to a percentage-based salary for all the providers. What happens to vacation time, holidays, sick leave, and continuing education time off in this scenario?
  • Percentage Payment Per Visit Does the Stark law make it illegal for an NP employed by an MD to get paid per visit by a percentage of what is reimbursed, instead of getting paid hourly or a salary?
  • Request to Change Medical Record A patient recently called, upset about something written in his medical record. He wants it changed and says he will sue. Does he have a case?
  • Do I Need More Than 1 DEA Number? I work part-time for a family practice office, and I will soon work part-time for a different office in a nearby city as well. Must I have 2 DEA numbers, one for each practice?
  • Witnessing a Surgical Consent Form In my workplace, we have the consent signed prior to anyone from the anesthesia department seeing the patient. Is this safe and ethical?
  • NP Billing for Hospice Care What is the current status of NPs regarding the provision of and billing for hospice care? Can NPs now direct and/or manage hospice care, once a physician has certified eligibility?