Cross-conflicting regulations health facility edition

by Tom aka Rusty Rustbelt

Health care thoughts: Cross-conflicting regulations health facility edition

The most recent regulatory question I had trouble answering. The situation is as follows (the state will remain nameless):

State nursing home inspectors: certain antibiotics cannot be administered for certain conditions without a three day lab culture being done first; if the nursing home administers certain antibiotics without the three day culture the facility, administrator and nurses are subject to citations and penalties.

State physician licensing board: physicians can order the administration of medications including antibiotics within the standards of practice, failure to do so may be considered malpractice State nurse licensing board: a nurse is to follow the orders of a licensed physician (or PA or NP supervised by a licensed physician) unless the orders fall outside the standards of practice or treatment is contraindicated (medication conflict for example); failure to do so may be subject to disciplinary proceedings

State nursing home inspectors: failure to follow physician orders makes the facility, administrator and nurses subject to citations and penalties, and possible referral to various licensing boards Office of the Inspector General: treatments which violate state or federal regulations (even unintentionally) may make the billing for such treatments an act of fraud.

So, a physician orders an antibiotic for a patient to be started immediately, in violation of the three day rule…….. the correct answer is?

(We did get a solution, sorta, will share that later.)

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