RN/LPN Scope of Practice in Home Health

[nursesandi1]

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?

[NRSKarenRN, BSN, RN]

moved to home health nursing forum

[bostonbakednurse]

I just read through this post and found it interesting. The original topic asked a question on what to do and asked for opinions.

Several people took the time to answer most likely based on personal and professional experience.

I agree with ryancarolinaboy. You know what they say about ASSuming.

[nursel56]

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.

What did you decide to do? Report the LPN? The agency?

[jmn126]

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!

This being said, i would be contacting not only the BON but Medicare also, no questions asked!!!!!

[HealthyNurse]

Even if you only suspect that something such as this is occuring, you have a professional and ethical obligation to report it. Make a report to the state department of health, or whoever in your state is responsible for licensing and certification. They will investigate and determine whether or not there is any validity to it. You should be able to make an anonymous complaint.