On February 18, 2014, Ohio Governor Kasich signed into law H.B. 139 permitting clinical nurse specialists (CNS), certified nurse-midwives (CNM), certified nurse practitioners (CNP) and physician assistants (PA) to admit patients to hospitals under certain conditions.
Under current law, only a doctor, dentist, or podiatrist who is a member of a hospital’s medical staff may admit a patient to the hospital (Ohio Revised Code 3727.06). However, H.B. 139 authorizes a CNS, CNM, or CNP to admit a patient to a hospital if three conditions are met.
- The CNS, CNM or CNP has a standard care arrangement with a collaborating doctor or podiatrist who is a member of the medical staff.
- The patient will be under the medical supervision of the collaborating doctor or podiatrist.
- The hospital has granted the CNS, CNM, or CNP admitting privileges and appropriate credentials.
Similarly, under H.B. 139, a PA may admit a patient to a hospital if the following conditions are met:
- The PA listed on an approved supervision agreement for a doctor or podiatrist who is a member of the hospital’s medical staff.
- The patient will be under the medical supervision of the supervising physician or podiatrist.
- The hospital has granted the PA admitting privileges and appropriate credentials.
The CNS, CNM, CNP, or PA is required to notify the collaborating or supervising doctor or podiatrist of the planned admission prior to admitting a patient.
Hospitals should take the following actions in order to permit a CNS, CNM, CNP, or PA to admit patients to the hospital:
- Review the new law and the requirements contained therein and determine how the hospital will assure compliance with the requirements.
- Amend the applicable privilege sets to permit the CNP, CNM, CNS, or PA to request admitting privileges; act upon requests for admitting privileges effective on/after the date the new law takes effect.
- Verify whether there are any medical staff or hospital policies that need to be updated with respect to admission/discharge of patients by a CNP, CNM, CNS or PA and amend accordingly.
- Verify whether there are any hospital computer systems/processes that need to be updated to reflect the ability of a CNP, CNM, CNS and/or PA to admit/discharge a patient.
- Determine what education/communication will be needed regarding the change to hospital staff, the medical staff, etc.
- The CNP, CNM, or CNS (if the CNS is required to have one) will need to revise their standard care arrangement with his/her collaborating collaborating doctor or podiatrist to permit the CNP, CNM, or CNS to admit a patient to the hospital in accordance with ORC 3727.06.