title: A modest proposal: nurse practitioners to improve clinical quality and financial viability in critical access hospitals.
abstract: Rural health care has achieved a new focus of attention with the passage of the Affordable Care Act (ACA). This article argues that nurse practitioners may be an important resource to help rural hospitals, especially critical access hospitals (CAH), achieve their mission of community service while protecting their always-delicate financial sustainability. Nurse practitioners' scope of practice is well suited to the needs of rural patients, and their ability to participate in expanding preventive services is especially essential in remote areas. Barriers to nurse practitioner practice include restrictive state laws and federal and state policies.
authors.affiliation: Lexington Regional Health Center, Lexington, NE 68850, USA. lmarsh@lexrhc.org
authors.forename: Leslie
authors.initials: L
authors.lastname: Marsh
authors.forename: Donna
authors.initials: D
authors.lastname: Diers
authors.forename: Allan
authors.initials: A
authors.lastname: Jenkins
mesh_terms: D064648:Critical Care Nursing / Q000191:economics*; D003695:Delivery of Health Care / Q000191:economics / Q000331:legislation & jurisprudence; D006780:Hospitals, Rural / Q000191:economics*; D006801:Humans; D009722:Nurse Practitioners / Q000706:statistics & numerical data*; D058991:Patient Protection and Affordable Care Act; D058996:Quality Improvement / Q000191:economics* / Q000331:legislation & jurisprudence; D012423:Rural Health / Q000191:economics* / Q000331:legislation & jurisprudence; D014481:United States; D000078329:Workforce
keywords: critical access; nurse practitioners; rural health care