Nursing Practice Considerations for Medicare’s Reimbursement Model of Rural Emergency Hospitals

IF 4.2 4区医学 Q1 NURSING

Journal of Nursing Regulation Pub Date : 2025-01-01 DOI:10.1016/S2155-8256(25)00033-X

Karen L. Weis PhD, RN C-OB, FAAN, Deena Woodall PhD, RN, Teale Ryan PhD, MS, RN, Lisa Larson PhD, RN

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引用次数: 0

Abstract

Background: The Consolidated Appropriations Act of 2021 (Public Law 116-260) established a Rural Emergency Hospital (REH) designation under the Medicare program. Guidance includes provider staffing requirements, but the nurse staffing recommendations conflict with state boards of nursing scope of practice requirements.

Purpose: To gain a perspective regarding the nurse staffing needed to provide 24/7 emergent care and patient observation for the REH reimbursement model.

Methods: A mixed methods design of ethnography and cross-sectional descriptive data were collected through unstructured field observations, face-to-face interviews, and focus groups to evaluate descriptive data on nurse education, skill mix, and competencies.

Results: Data were collected from nursing personnel and leadership (N = 45) at four critical access hospitals (CAHs) in Kansas. The nursing workforce sample was predominantly registered nurses (87.8%) with associate degrees in nursing (51.3%). Findings reflect the need for a highly skilled, flexible staff with strong critical thinking skills and the ability to function within their full scope of practice.

Conclusions: The REH reimbursement model and associated policies do not address appropriate nurse staffing within the required scope of nursing practice and services. Initial assessment and patient transports are key factors in the REH designation, both of which require the support of registered nurses. The nurse staffing recommended for REHs does not adequately meet the needs of the service model.

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来源期刊

Journal of Nursing Regulation NURSING-

CiteScore

4.60

自引率

12.50%

发文量

审稿时长

54 days

期刊介绍： Journal of Nursing Regulation (JNR), the official journal of the National Council of State Boards of Nursing (NCSBN®), is a quarterly, peer-reviewed, academic and professional journal. It publishes scholarly articles that advance the science of nursing regulation, promote the mission and vision of NCSBN, and enhance communication and collaboration among nurse regulators, educators, practitioners, and the scientific community. The journal supports evidence-based regulation, addresses issues related to patient safety, and highlights current nursing regulatory issues, programs, and projects in both the United States and the international community. In publishing JNR, NCSBN''s goal is to develop and share knowledge related to nursing and other healthcare regulation across continents and to promote a greater awareness of regulatory issues among all nurses.