Based on current regulations, which action is reimbursable and appropriate for implementation by the NP?

• A. Performing the admission examination for an SNF patient who is a Medicare recipient
• B. Providing the initial certification of hospice eligibility
• C. Completing the first monthly examination for an SNF patient who is a Medicare recipient
• D. Serving as the attending provider for a Medicare patient who requires hospice care

Answer: (D)

The essential idea is that Medicare hospice care requires a designated attending provider who certifies terminal illness and oversees the plan of care. A nurse practitioner, when licensed and practicing within their state scope, can serve as that attending provider for a Medicare patient needing hospice. This role aligns with Medicare policies that allow non-physician practitioners to perform the attending physician duties for hospice, making the NP’s services reimbursable.

Thus, having the NP act as the supervising attending provider for hospice care ensures appropriate medical oversight and certification of terminal illness under Medicare, which is why this option is the best fit for reimbursable and appropriate practice.

Typically, the admission exam for a skilled nursing facility patient, the initial hospice eligibility certification, and the first monthly SNF examination are more often physician-centered tasks or require specific physician involvement for reimbursement, depending on state law and payer rules.