RN/LPN Scope of Practice in Home Health

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Hi everybody! I need some input. I was the Director of Nursing for a Home Health Agency until recently but since I've left, I have been informed that the agency is using an LPN in the scope of an RN. Now, I'm not sure if the agency is knowingly doing this. This LPN has been attending a distance learning RN program and just completed here clinical final testing. If the agency was misled to believe that the completion of this final test promoted the LPN to an RN (and they were foolish enough not to verify it on the DOH website), they could be allowing her to be performing supervisory visits, etc mistakenly. But if they are allowing her to perform as an RN and having the present DON sign the documentation, that would be different. Should I report the LPN, the Agency? What do you think?

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Specializes in Addiction, Psych, Geri, Hospice, MedSurg.

I think I would definitely let someone know. Of course the completion of anything BUT the NCLEX does not allow an LPN to function as an RN, period.

Just in case they are mistaken, somehow, I would bring it to their attention - and quickly- before reporting the facility... UNLESS they are knowingly allowing this (such as in anticipation of her becoming an RN).

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Specializes in LTC, Memory loss, PDN.

I think you didn't leave on good terms.

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Do not report this based on an assumption. If you know something to be the fact, then report, if you feel you must. Doubt the agency is stepping on it here. But if they are, then, by the time anything comes of it, the LPN will have obtained an RN license.

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Specializes in ICU.
Hi everybody! I need some input. I was the Director of Nursing for a Home Health Agency until recently but since I've left, I have been informed that the agency is using an LPN in the scope of an RN. Now, I'm not sure if the agency is knowingly doing this. This LPN has been attending a distance learning RN program and just completed here clinical final testing. If the agency was misled to believe that the completion of this final test promoted the LPN to an RN (and they were foolish enough not to verify it on the DOH website), they could be allowing her to be performing supervisory visits, etc mistakenly. But if they are allowing her to perform as an RN and having the present DON sign the documentation, that would be different. Should I report the LPN, the Agency? What do you think?

Pardon me for being so blunt, but as you no longer work at this company, what business is it of yours? It's one thing to report a KNOWN allegation, with substantial FACT to back it up, but to call and report "what you think" is another thing all together. Keep your nose to the ground and mind your own business, dear. How do you know that this particular LPN isn't a graduate nurse now that she/he has passed clinicals. Just because someone hasn't sit for state boards doesn't mean they can't be a grad nurse...

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Specializes in Home Health.
Hi everybody! I need some input. I was the Director of Nursing for a Home Health Agency until recently but since I've left, I have been informed that the agency is using an LPN in the scope of an RN. Now, I'm not sure if the agency is knowingly doing this. This LPN has been attending a distance learning RN program and just completed here clinical final testing. If the agency was misled to believe that the completion of this final test promoted the LPN to an RN (and they were foolish enough not to verify it on the DOH website), they could be allowing her to be performing supervisory visits, etc mistakenly. But if they are allowing her to perform as an RN and having the present DON sign the documentation, that would be different. Should I report the LPN, the Agency? What do you think?

Until the LPN passes the State Board exam and receives a license, she is is NOT an RN and cannot function in that capacity. Yes, I would call the state and Board of Nursing on this. It's BS, the Agency is probably thinking they will be saving money by doing this - bet she is paid at LPN rate!

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Specializes in Home Health.
Pardon me for being so blunt, but as you no longer work at this company, what business is it of yours? It's one thing to report a KNOWN allegation, with substantial FACT to back it up, but to call and report "what you think" is another thing all together. Keep your nose to the ground and mind your own business, dear. How do you know that this particular LPN isn't a graduate nurse now that she/he has passed clinicals. Just because someone hasn't sit for state boards doesn't mean they can't be a grad nurse...

Medicare COP's require that the RN be 'Licensed'. It is in the regs.

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Specializes in Home Health.

If the nurse just finished clinicals for RN, when is next NCLEX exam?

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Specializes in Home Health.

If anyone thinks fraud is being committed, it should be reported. The higher ups can decide.

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Specializes in Home Health.
I think you didn't leave on good terms.

Haha, I didn't leave a job on good terms years ago either. It did not make it okay that the DON (home health) asked me to get extra blank nurses notes signed by an elderly patient who had dementia that was fairly severe. Evidently the company was going to make it look like they made the required number of visits so that they could be paid by Medicare, without making the visits. Again, I did leave on terms that were not so good, I resigned the following Monday when the DON asked me if I got the extra blank notes signed by the patient and I said I had not. I reported this to DHH and they would not investigate because I had resigned the job. How stupid is that! I am beginning to accept the fact that Medical Care in the US is based on stupid!

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Specializes in ICU.

Again, nobody likes a busybody! well, nobody except the busybody themselves! I will remain by my original statement and say that if you don't work there, and you have no connection to the place, then it's none of your business...I know that it's hard for some people to get that concept sometimes. Heresay is how malicious gossip gets started...

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It has nothing to do with rumours or being a busy body. I worked hard for my license and I don't feel that anybody should impersonate as or present themselves as a licensed professional and get away with it. Excuse me as well for being blunt but are you even a Registered Nurse? Because you don't seem to realize the responsibility that the title Registered Nurse holds. And, I dare say, you sound very angry about things being reported to the nursing board. If everybody "minded their own business" and allowed things, that to most of the world is wrong, than why bother having a license at all or differentiating between an RN and an LPN? Wrong is wrong and fraud is fraud. There is no middle ground. And perhaps that belief is why I am successful as a Director. Good Luck to you and God Bless.

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