NYSHFA Staff Met with NYSED Executive Secretary to the Board of Nursing

Nancy Leveille and Karen Morris in Clinical & Quality

Karen Morris and Nancy Leveille, NYSHFA, met with NYS Education Department (SED) staff Suzanne A. Sullivan, Executive Secretary, Board of Nursing and Ann Bentzen, Associate in Nursing Education, on Wednesday June 3, 2015 to discuss nurse practice issues as they relate to Skilled Nursing (SNF) and Assisted Living (AL) facilities.  A variety of topics were discussed but the following were the focal points:

  1. The Public Health Law for E- Prescribing and the issues SNF and AL clinicians still face to meet this new deadline. NYSHFA updated SED on the issue  of nurses not being able to use their ability to take verbal and telephone orders and enact them immediately unless the prescriber had signed off in the E- prescribing system. Both agreed we cannot have a delay in obtaining needed medications for residents in these settings. We discussed the on call medical coverage systems and the potential number of prescribers that may have to enter into a SNF/AL EHR or vendor systems to interface with e-prescribing. All agreed there are specific concerns still left unanswered. Follow up will continue with the Bureau of Narcotic Enforcement and the legislators as needed.

  2. Registered Nurse Staffing Hours in SNF: The SED staff felt strongly about the complexity of care needs of residents being admitted to SNF and the need for registered nurses to provide this higher level care. Ms. Sullivan noted they receive many inquiries and specific problems from nurses about the scope of practice of LPN vs RN in these settings and are concerned about the outdated regulations requiring only limited RN hours. She emphasized that she will hold the individual licensed staff accountable to working within their scope of practice and is reporting specific issues related to scope of practice, sufficient staffing and regulatory concerns to DOH’s Bureau of Survey and Surveillance. NYSHFA discussed the difficulty in hiring nurses in many of the rural areas and competition they face due to the hospitals’ ability to recruit and pay higher wages. We also discussed alternative staffing ideas such as use of creative shifts and highlighted the increasing utilization of nurse practitioners into the setting and extending their hours into the evening and weekends. NYSHFA will also work with the DOH in assessing/ preventing deficiencies of this nature.

NYSHFA will maintain an open dialogue with the SED staff and encourage our members to assess your staffing levels according to your increase in complexity of care to ensure safety and adherence to resident care standards. As we have noted in other member mailings, staffing levels and retention and consistency of staff are being highlighted in many of the NYS and national incentive programs.

Nancy Leveille

Senior Director, Member Operational Support
518-462-4800, ext. 20

Karen Morris

Director, Clinical & Quality Services
518-462-4800, ext. 15