Bipartisan legislation introduced in the U.S. House of Representatives could in the opinion of one clinical expert be an “excellent step forward in removing barriers to quality care for patients” in skilled nursing facilities (SNFs).  

Reps. Jen Kiggans (R-Va.) and Debbie Dingell (D-Mich.) introduced the “Enhancing Skilled Nursing Facilities Act” to empower nurse practitioners, physician assistants, and clinical nurse specialists to provide certain care in SNFs “to streamline care, reduce delays, and improve access for patients on Medicare and Medicaid.”

The pair said studies show that between 2010 and 2020 the number of geriatric physicians decreased nearly 13 percent, yet the ranks of geriatric nurse practitioners increased 125 percent.

“Under current federal law, an NP, PA, or CNS can perform and bill for the required clinical assessments; however, a physician must also do this assessment and can be reimbursed, which results in duplicative billable services,” the lawmakers said.

Data also shows that when NPs are authorized to provide this care, patients have positive outcomes, they added.

“NPs, PAs, and CNSs can fill gaps in care caused by physician shortages improving patient access, reducing wait times, and increasing patient satisfaction.”

Justin Molignoni, NP, clinical lead for Comprehensive Rehab Consultants (CRC), a provider of physiatry and psychiatry services to long-term care facilities, said the bill focuses more on the primary care side of the equation and really won't impact his group’s work, but sees the positives if this legislation becomes reality.

“This is an excellent step forward in removing barriers to quality care for patients and decreasing the need for duplicative visits by primary care. As admission visits for SNFs in the past had to be always completed by an MD/DO, this new introduced legislation will remove this hurdle and expand admission capabilities for many facilities as a limiting factor at time was the ability to secure and MD/DO in addition to an NP/PA,” he said. 

Groups like the American Academy of Physician Associates (AAPA), the National Association of Clinical Nurse Specialists, and American Association of Nurse Practitioners back the legislation.

“With more than 190,000 PAs nationwide delivering high-quality care across every specialty, the introduction of this bill is essential to ensuring skilled nursing facilities can effectively utilize services provided by PAs,” said AAPA President Todd Pickard

Read the bill here. Read the one-pager here.

Questions or comments? Contact Patrick Connole at pconnole@parkplacelive.com.