LPN doing assesments?

Specialties Geriatric

Updated:   Published

I work in LTC in a Nursing home type facility in MN. We get admissions later into the evening shift. Besides having 22 residents to do heavy med passes for along with treatments , our facility makes us do admissions. There is no desk nurse/person to help and the charge nurse who is an LPN is busy with shift call ins or having to take patients herself and cover a wing. All assesments such as the braden scale, pain assesment, skin assesment, tissue tolerance assesment, nursing assessment, bladder assesment, start of temporary care plan, all orders ect have to be done by myself. A RN does not see these patients when they come into our facility. Is it legal or within my scope of practice to do assesments? Assesments are not cosigned by an RN. I was taught that LPN's cannot do assesments.

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I don't know what the scope of practice for LPNs is in MN but in NY they get around the "assessment" issue by calling it data collection which LPNs are allowed to do. They make us do the work and then the RN supervisor will sign off on it.

Check with your State BON.

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LPNs have been doing assessments, admissions and everything else an RN does , even IVs if you are certified. 22 patients is really a good ratio, well at least its "good" if you compare that to some of the other nurse patient ratios across the country. It would be best to check with your BON to clarify your scope of practice. Nursing homes have different rules than hospitals.Nursing homes utilize their LPNs MUCH more than hospitals.

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I work in LTC in a Nursing home type facility in MN. We get admissions later into the evening shift. Besides having 22 residents to do heavy med passes for along with treatments , our facility makes us do admissions. There is no desk nurse/person to help and the charge nurse who is an LPN is busy with shift call ins or having to take patients herself and cover a wing. All assesments such as the braden scale, pain assesment, skin assesment, tissue tolerance assesment, nursing assessment, bladder assesment, start of temporary care plan, all orders ect have to be done by myself. A RN does not see these patients when they come into our facility. Is it legal or within my scope of practice to do assesments? Assesments are not cosigned by an RN. I was taught that LPN's cannot do assesments.

I live in Florida. As a LPN, I do most of the assessments and admissions with no RN intervention at all. Maybe it is different in your state.:nurse:

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In my facility, (home health care) we have been told that LPNs cannot legally perform assessments as far as Medicaid/Medicare are concerned. Therefore, all our assessments are performed by RNs.

Several LPNs friends working the floor at a large hospital here in town tells me they have the same policy. Go figure!

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Specializes in Vascular Access Nurse.

In many LTC facilities, the LPN does many of the assessments, including admission. At some point an RN will sign off, perhaps only on the MDS. I'm an LPN and I do all the MDS', including the admission one, but an RN has to sign that my assessment is accurate. I also write all the care plans for nursing. Our LPN's do the Braden, pain scale, admission assessment, skin assess, temporary care plans, etc. With only one RN required in the facility for 139 residents, she's not going to be able to do all admissions. 22 residents sounds reasonable. Our nurses (RN or LPN) have a minimum of 25 and often more than that. They also don't have a ward clerk to help out, and have to deal with not only the meds, but the families/visitors who are more numerous on second shift, not to mention the docs who wait ntil the end of their office hours to return phone calls. It's pretty much the norm. Welcome to long term care!! :bugeyes:

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Specializes in Vascular Access Nurse.
in my facility, (home health care) we have been told that lpns cannot legally perform assessments as far as medicaid/medicare are concerned. therefore, all our assessments are performed by rns.

several lpns friends working the floor at a large hospital here in town tells me they have the same policy. go figure!

i'm an lpn, and i do all of the medicare and medicaid assessments. an rn has to sign on line r2b, but she didn't do the assessment, she's just verifying that my information is correct. it works well for us.:nuke:

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Specializes in LTC, Hospice, Case Management.
i'm an lpn, and i do all of the medicare and medicaid assessments. an rn has to sign on line r2b, but she didn't do the assessment, she's just verifying that my information is correct. it works well for us.:nuke:

r2b signature only states that the mds assessment is complete. it does not imply that the assessment is accurate. refer to rai manual

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Specializes in Vascular Access Nurse.
r2b signature only states that the mds assessment is complete. it does not imply that the assessment is accurate. refer to rai manual

i stand corrected.

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Specializes in Geriatrics, WCC.

According to MN BON, an LPN can not perform assessments. They can observe/monitor, gathering information. Everything you are doing for admissions is what my nurses are doing in our facility whether they are LPN's or RN's. There are just creative ways to get around every corner.

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Specializes in Gerontology, Med surg, Home Health.

I worked for one facility in which the LPN's could start and hang IVs but were not allowed to do the oral assessment and count a patient's teeth on admission. Hmmmm...you can stick a potentially injury causing catheter into my arm but you can't say "open up" and count to 32?!?! That stupid policy didn't last very long.

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Totally legal in PA.

If LPNs couldn't do this or you needed an RN to do all of these, our LTCs would fall apart.

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