[QUOTE]Originally posted by Jammer
[B]Ok, here is the situation. I have been a LPN in the same SNF for 10 years. I have been trained and I am skilled in med administration using the pyxis system, IV antibiotic administration, IV insertion, blood draws, EKG's, RXs, ect., ect.
Last night was the very first time in 10 years that LPN's were excluded from a nursing meeting. My charge nurse, whom I have a great relationship with, informed me that one of the things that came up in the meeting was that the Administrator stated that beginning very soon, she wanted ONLY RNs to do the nurses notes. Her stated reason was "because of Medicare regs".
First of all I can't possibly believe that there is any Medicare regs that state that it has to be an RN that does the nurses notes. Secondly, this is the biggest slap in the face that I can imagine. I've been doing 90% of the charting on my shift for almost 10 years now. I write at least as good a note or better than anyone else on the unit.
I have dug around the net for Medicare regs but am coming up with nothing so far that is quite that specific.
So, has anyone here ever heard of anything quite so freaking rediculous? Does anyone know of any such Medicare regulations?
Can you lead me somewhere where I could acquire the info I need?
Jammer, I inserted a copy of a reg which may help with what your looking for. I know it sounds petty, but the reg requires a registered professional nurse, not a liscenced one. This may be what they are refering to. Also, some BON require the initial daily assessments of patients to be done by a registered nurse and then subsequent ones can be performed by LPN's. Contact your BON to check.
271.4 COVERAGE OF SERVICES 11-87
Changes to such plans also may be made pursuant to oral orders given by the pathologist to another qualified speech pathologist, by the occupational therapist to another qualified occupational therapist, or by the physical therapist to another qualified physical therapist, or by the therapist or pathologist to a registered professional nurse on the staff of the provider. Such changes must be immediately recorded in the patient's records and signed by the individual receiving the orders. While the physician may change a plan of treatment established by the pathologist or therapist providing such services, the therapist or pathologist may not alter a plan of treatment established by a physician.