Issue: Long term care facilities mid-level provider verbal orders

On August 3, 2004 a meeting was held with the PSPA, Hospital and Healthsystems Association of Pennsylvania, Department of Health’s Bureau of Facility Licensure and Certification, Pennsylvania Nursing Home Association and the Pennsylvania Medical Directors Association.

In mid July, the DOH had posted a notice on their message board that it was their opinion that PAs and NPs could not give a verbal order in a LTCF.

This meeting was called to work out possible solutions. The DOH did concede they would accept orders signed and faxed from a mid-level at this time. They had agreed to consider developing an interim policy to the LTCF Act to permit it. In mid October, a letter was sent from PSAP and HHAP to Dr. Calvin Johnson, Secretary to the DOH asking for an update on the creation of this interim policy. No response has been received to date.

The DOH has stated they will consider requests for exceptions to Section 211.3 (oral orders) of the DOH regulations governing Long Term Care Facilities submitted by nursing homes. In order for the exception to be considered, the LTCF must develop a policy that states that the provider giving the verbal order would speak directly to the nurse who was going to carry out the orders.

A letter requesting an exception to Section 211.3 (oral orders) of the LTCF Act should be sent to:
William Bordner, Director
Department of Health
Division of Nursing Care Facilities
Room 526
Health and Welfare Building
Harrisburg, PA 17120
Phone (717) 787-1816
Fax (717) 772-2163
Email paexcpt@health.state.pa.us

If you have further problems, questions or concerns regarding the giving of a verbal order in a LTCF, please contact the society office at pspa@pspa.net.