title: Experts recommend strategies for strengthening the use of advanced practice nurses in nursing homes.
abstract: In 2003, The John A. Hartford Foundation Institute for Geriatric Nursing, New York University Division of Nursing, convened an expert panel to explore the potential for developing recommendations for the caseloads of advanced practice nurses (APNs) in nursing homes and to provide substantive and detailed strategies to strengthen the use of APNs in nursing homes. The panel, consisting of nationally recognized experts in geriatric practice, education, research, public policy, and long-term care, developed six recommendations related to caseloads for APNs in nursing homes. The recommendations address educational preparation of APNs; average reimbursable APN visits per day; factors affecting APNs caseload parameters, including provider characteristics, practice models, resident acuity, and facility factors; changes in Medicare reimbursement to acknowledge nonbillable time spent in resident care; and technical assistance to promote a climate conducive to APN practice in nursing homes. Detailed research findings and clinical expertise underpin each recommendation. These recommendations provide practitioners, payers, regulators, and consumers with a rationale and details of current advanced practice nursing models and caseload parameters, preferred geriatric education, reimbursement strategies, and a range of technical assistance necessary to strengthen, enhance, and increase APNs' participation in the care of nursing home residents.
authors.affiliation: John A. Hartford Foundation Institute for Geriatric Nursing, New York University, Steinhardt School of Education, Division of Nursing, NY, NY 10003, USA. mathy.mezey@nyu.edu
authors.forename: Mathy
authors.initials: M
authors.lastname: Mezey
authors.forename: Sarah Greene
authors.initials: SG
authors.lastname: Burger
authors.forename: Harrison G
authors.initials: HG
authors.lastname: Bloom
authors.forename: Alice
authors.initials: A
authors.lastname: Bonner
authors.forename: Mary
authors.initials: M
authors.lastname: Bourbonniere
authors.forename: Barbara
authors.initials: B
authors.lastname: Bowers
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Burl
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Capezuti
authors.forename: Diane
authors.initials: D
authors.lastname: Carter
authors.forename: Jacob
authors.initials: J
authors.lastname: Dimant
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Jerro
authors.forename: Susan C
authors.initials: SC
authors.lastname: Reinhard
authors.forename: Marilyn
authors.initials: M
authors.lastname: Ter Maat
mesh_terms: D000368:Aged; D004511:Education, Nursing, Graduate; D005851:Geriatric Nursing / Q000193:education; D006707:Homes for the Aged / Q000191:economics; D006801:Humans; D006278:Medicare / Q000191:economics; D009720:Nurse Clinicians / Q000191:economics / Q000706:statistics & numerical data*; D009722:Nurse Practitioners / Q000191:economics / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000191:economics; D010560:Personnel Selection / Q000706:statistics & numerical data; D011361:Professional Competence; D012051:Reimbursement Mechanisms / Q000191:economics; D013038:Specialization; D014481:United States; D000078329:Workforce