Admitting Privileges for NP's

nomadcrna, DNP, CRNA, NP · Nov 15, 2011

The point is that you CAN get admitting privileges and membership on med. staff as a NP. I guess you could NOT admit medicare patients. :)

I had the same privileges at my last hospital in Montana. Most times you have to work for it. Education and building relationships while being an excellent provider helps greatly.

I believe ALL NPs should strive to change NP practice towards independence and part of that includes changing the old norm and becoming full members of the medical staff and not just allied health professionals.

The federal government's legislative powers are limited to those laws that are authorized by the Constitution. Any federal law that is not within the authorities granted are unconstitutional laws, and therefore are laws that the States do not necessarily have to worry about.

The 10th Amendment, which specifically states that powers not delegated to the federal government(by the constitution), nor prohibited to the States, belong to the States.

Nowhere in the constitution do I see anything about medical practice. But in any case!

These are not laws, they are regulations. The feds can only dictate regulatory policy towards medicare patients. They can't dictate your practice. If the state (and hospital credentials) allows you to admit patients, then you can, period.

The feds can withhold payment or take away the hospital's conditions of participation. They can do absolutely nothing about your practice.

Our hospital just went through a STATE inspection and passed. They actually commented on how they liked our bylaws. I am going to check with the billing department though. Maybe they have something stating that the one physician (chief of staff) who has a competing clinic and is gone every 3rd month per his contract has general oversight on medicare patients. I'm curious now. My clinic bills for my services in the ER and any inpatients. The hospital bills for their Part A of course.

I am curious.

I do believe many of these regs. will be changing very shortly.

BTW, Arizona, Oregon and Washington state laws specifically allow NP to independently admit patients to the hospital.

nomadcrna, DNP, CRNA, NP · Nov 15, 2011

http://www.aanp.org/AANPCMS2/LegislationPractice/Nurse+Practitioner+Elected+Medical+Staff+President.html

Nurse Practitioner Elected Medical Staff President

Bob Donaldson is clinical director of emergency medicine and president of the medical staff at Ellenville Regional Hospital in New York. His current projects sound much like any medical staff president’s goals. What might surprise you is that Donaldson is not a physician but a nurse practitioner. He was elected to this influential position by his physician colleagues and enjoys great support from the hospital’s medical staff.

As an admitting provider in the ER, the hospital’s medical staff got to know Donaldson well and in 2008 he was invited to be on the team to review and revise the medical staff bylaws. “The medical staff, all physicians, voted to give equal rights to nurse practitioners on the medical staff,” says Donaldson. “Which means if you have a practice here and you are involved in admissions to this hospital, that you are equal to a doctor as far as privileges at the facility and within the medical staff.”

In another unusual move, Donaldson’s work in the ER means he admits patients to the hospital and its various providers every day, so the hospital decided to give him attending status. Donaldson says that in 2009 the hospital needed to fill the position of medical staff president and was having difficulty attracting volunteers. So he put his name in the hat. “I look at that as like anything else nurse practitioners have done,” he says. “There’s a void and we step in and we do the job. So that’s what I did.” Clearly, this hospital has collaborative practice figured out.

Source: Excerpted