HospitalInspections.org

The Hospital identified staff which included 4 Advanced Registered Nurse Practitioners (ARNP), with 3 chosen for review. Based on document review and staff interview for 2 of 3 sampled ARNP's the Hospital failed to have a physician periodically review and sign their medical records (staff A & B).

Findings include:

- Review of the Hospital Medical Staff Bylaws, last dated as approved on 8/26/08, documented that "For the purposes of these Bylaws, the following definitions shall apply. 1.ALLIED HEALTH PROFESSIONAL or AHP means a Dependent Practitioner or a Mid-Level Practitioner (i.e.ARNP {Advanced Registered Nurse Practitioner}, Physician Assistant, and CRNA {Certified Registered Nurse Anesthetist}). Article 9-Allied Health Professionals section 9.1(a) directed "The Board Permits an Allied Health Professional (AHP) to provide patient care services without appointment to the Medical Staff...An AHP will provide services only under supervision of a member of the Medical Staff..." Article 9.3-1 MIDLEVEL PRACTITIONERS stated-"Midlevel Practitioners may provide inpatient services subject to the oversight of a physician..."

Review of Personnel files on 2/23/12 revealed 2 of 3 ARNP's (A & B) lacked documentation of Physician oversight of their practice or Credentialing for their area of Practice (Nuclear Medicine).

Interview with Hospital Administrative staff member C, on 2/23/12 at 3:00pm, verified the 2 ARNP's started working at the Hospital in 2004, under the old practice of physician oversight and the Hospital failed to change their bylaws and/or Credential the ARNP's when they changed to their current independent practice.

The Hospital identified staff which included 4 Certified Registered Nurse Anesthetists (CRNA), with 4 reviewed. Based on document review and staff interview the Hospital failed to ensure

Findings include:

- Review of the Hospital Medical Staff Bylaws, last dated as approved on 8/26/08, documented that "For the purposes of these Bylaws, the following definitions shall apply. 1. ALLIED HEALTH PROFESSIONAL or AHP means a Dependent Practitioner or a Mid-Level Practitioner (i.e.ARNP {Advanced Registered Nurse Practitioner}, Physician Assistant, and CRNA {Certified Registered Nurse Anesthetist}). Article 9-Allied Health Professionals section 9.1(a) directed "The Board Permits an Allied Health Professional (AHP) to provide patient care services without appointment to the Medical Staff...An AHP will provide services only under supervision of a member of the Medical Staff..." Article 9.3-1 MIDLEVEL PRACTITIONERS stated-"Midlevel Practitioners may provide inpatient services subject to the oversight of a physician..."

Review of Personnel files on 2/23/12 revealed 2 of 4 CRNA's (D, E) lacked documentation of Physician oversight of their practice or Credentialing for their area of Practice (Anesthesiology).

Interview with Hospital Administrative staff member C, on 2/23/12 at 3:00pm, verified the 2 CRNA's both started employment in 2007 and the Hospital failed to provide the physician oversight as documented in their Medical Staff Rules and Regulations and/or Credential the CRNA's.