title: Trends in Nurse Practitioner and Physician Assistant Practice in Nursing Homes, 2000-2010.
abstract: OBJECTIVE
  To examine nurse practitioner (NP) and physician assistant (PA) practice in nursing homes (NHs) during 2000-2010.
  
  
  METHODS
  Data were derived from the Online Survey Certification and Reporting system and Medicare Part B claims (20 percent sample).
  
  
  METHODS
  NP/PA state average employment, visit per bed year (VPBY), and providers per NH were examined. State fixed-effect models examined the association between state regulations and NP/PA use.
  
  
  RESULTS
  NHs using any NPs/PAs increased from 20.4 to 35.0 percent during 2000-2010. Average NP/PA VPBY increased from 1.0/0.3 to 3.0/0.6 during 2000-2010. Average number of NPs/PAs per NH increased from 0.2/0.09 to 0.5/0.14 during 2000-2010. The impact of state scope-of-practice regulations was mixed.
  
  
  CONCLUSIONS
  NP and PA scope-of-practice regulations impact their practice in NHs, not always as intended.
authors.affiliation: Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY.|Canandaigua VA Medical Center, Canandaigua, NY.|Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI.
authors.forename: Orna
authors.initials: O
authors.lastname: Intrator
authors.affiliation: Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI.|Department of Gerontology and Gerontology Institute, John W. McCormack Graduate School of Policy & Global Studies, University of Massachusetts Boston, Boston, MA.|Center for Gerontology & Health Care Research, Brown University School of Public Health, Providence, RI.
authors.forename: Edward Alan
authors.initials: EA
authors.lastname: Miller
authors.affiliation: Center for Gerontology & Health Care Research, Brown University School of Public Health, Providence, RI.|Department of Gerontology, John W. McCormack Graduate School of Policy & Global Studies, University of Massachusetts Boston, Boston, MA.
authors.forename: Emily
authors.initials: E
authors.lastname: Gadbois
authors.affiliation: Department of Economics, Brown University, Providence, RI.
authors.forename: Joseph Kofi
authors.initials: JK
authors.lastname: Acquah
authors.affiliation: Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI.|Center for Gerontology & Health Care Research, Brown University School of Public Health, Providence, RI.|ProvidenceVA Medical Center, Providence, RI.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Makineni
authors.affiliation: Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI.|Center for Gerontology & Health Care Research, Brown University School of Public Health, Providence, RI.|ProvidenceVA Medical Center, Providence, RI.
authors.forename: Denise
authors.initials: D
authors.lastname: Tyler
mesh_terms: D006302:Health Services Research; D006707:Homes for the Aged / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D009722:Nurse Practitioners / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000639:trends*; D009735:Nursing Homes / Q000706:statistics & numerical data / Q000639:trends*; D010823:Physician Assistants / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000639:trends*; D014481:United States
keywords: Medicare claims; Online Survey Certification and Reporting (OSCAR) system; organization of medical staff; physician visits in nursing homes; scope-of-practice