F712: Physician Visits – Frequency/Timeliness/Alternate NPPs

This change to the SOM clarifies which types of practitioners may perform certain required services and in which settings those services may be performed.

Skilled Nursing Facilities

In the SNF setting, non-physician practitioners (NPPs) may not perform the initial comprehensive visit or sign admission orders. All NPPs may perform other required visits and medically necessary visits, and may sign related orders. An NPP who is not a facility employee may sign certifications and recertifications if permitted by state law.

Nursing Facilities

In the NF setting, all NPPs may perform and sign other medically necessary visits and orders. NPPs who are employed by the facility may not perform an initial comprehensive visit, provide admission orders, or perform other required visits. NPPs who are not employed by the facility are permitted to perform an initial comprehensive visit, provide admission orders if a physician has personally provided a recommendation in writing for admission before the resident's admission, and perform other required visits and sign related orders.