NP in LTC

Trauma Columnist · Aug 11, 2012

Hmmm - in my area, the Manor Care NHs have one NP to about 300 beds.

Advanced Practice Columnist / Guide · Aug 11, 2012

I don't think the number is defined in LTC. There are rules on the minimum timing of physician visits and NP's can be delegated to take the physician role as long as there is a physician medical director (typically, one every 30 days for first 90 days). Depending on the type of residents seen (i.e., higher percentage of residents with frequent changes in status), the visits can be more frequent as necessary.

I am not sure what you meant by short-term rehab. Are you referring to the 90 day Medicare admission to an LTC? The same rules as above will apply in those cases. Acute in-patient rehab hospitals are different. I worked in one as an NP when I first graduated and the patients are seen everyday so there is a higher need for more providers.

See:

http://www.amda.com/members/advocacy/physicianvisits/physicianvisits.pdf

http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/downloads/SCLetter04-08.pdf

rich2008 · Aug 12, 2012

Thanks!

300 patients for one NP seems like alot!

Juan, thanks for the links. I was trying to figure out what a patient load would be for a part time job. If a facility for example had 1/3 of the beds as sub-acute rehad and 2/3 as long term. How many residents would equate to 5 days a week for an NP and how many would be 3 days a week. I know there are probably no standards but maybe there is some rough ideas?

Trauma Columnist · Aug 14, 2012

Although not LTC I do dialysis rounding and see 200 plus pts every week and I drive 300-400 miles per week to do so. I don't think 300 is that bad at all. I know an NP that does this in a large NH .