The role of advanced registered nurse practitioner (ARNP) has been taking on greater significance in recent years by addressing the gap created with the shortage of MDs as well as by meeting the requirements of patient-centered medical homes and accountable care organizations. ARNPs are becoming more widely-recognized as providers of high quality, safe, effective care, to oftentimes diverse patient populations in a variety of settings. One such setting is the skilled nursing facility (SNF) where the ARNP can concentrate on restoring patients’ independence and providing a safe transition of care.

The SNF-based ARNP is able to evaluate and manage patient care so that the facility nurse does not have to wait for consultation with or approval from the primary care physician. This can include, but is not limited to, primary care management, wound care, mental health care and behavior management, risk management, and medicine therapy. ARNPs are able to order diagnostic/therapeutic tests, secure medical devices/supplies, counsel and educate patients and their families, prescribe medicine, and now in the State of Florida prescribe controlled substances. In the presence of an in-house ARNP, SNF nursing staff is able to improve their technical nursing skills, becoming more aware of changing conditions and more effective response methods.
 
This on-site ARNP model comes at a time when Medicare policy makers are evaluating every aspect of payment incentives to healthcare providers and CMS is embarking on a quality-based system. An ARNP’s role is essential in meeting the needs of residents and cutting overall medical costs throughout the continuum of care, especially in reducing hospital readmissions. The ARNP is hyper-focused on managing every aspect of the patient’s needs including care planning and, in most cases, alleviating some of the discomfort and uneasiness that can accompany re-hospitalization.
 
Within the SNF setting, ARNPs are instrumental in helping patients and residents transition through the continuum of care. They can provide necessary education regarding medical needs and instructions on current medical diagnosis, required medical therapies and medical outcomes as it pertains to their current medical condition. The ARNP is knowledgeable in a multitude of health settings including training for those returning home or to a different residential setting. The ARNP also facilitates communication among patients/residents, family members/caregivers, and physicians, furthering optimal patient care.
 
ARNPs are not only registered nurses with a lifetime of nursing experience, ARNPs are medically-trained and perform the majority of duties outlined by a primary care physician. They are automatous in practice and collaborate with physicians to deliver superior care. With a foundation strongly-rooted in evidenced-based medicine, ARNPs practice under their own license and collaborate with physicians to deliver superior care. Their contribution to the improved management and efficiency of care in the SNF environment is making for healthier patients and reductions in overall healthcare costs.