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Residents and inpatient admissions orders

Residency Program Insider, March 3, 2017

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With CMS regulations making inpatient admission orders an express condition of Medicare payment, questions have emerged over whether medical residents may admit Medicare patients. According to CMS’ admissions regulations, an ordering practitioner must be a qualified and licensed practitioner with admitting privileges at the hospital as permitted by state law and be knowledgeable about the patient's hospital course, medical plan of care, and current condition.

Some residents may be able to serve as the ordering practitioner but it requires a case-by-case determination. The GME experts at global law firm Dentons point to three elements that will determine if a resident may function as an ordering practitioner for Medicare patients:
•    The resident's medical licensure status. Although a resident may have a medical license, some states offer restricted licenses. These permit a resident to perform certain hospital activities but may not authorize him or her to make admission decisions.
•    The institution's medical staff bylaws. The hospital's medical staff must grant a properly licensed resident admitting privileges so an understanding of the bylaws is required.
•    The resident’s knowledge. Even if a resident is properly licensed with admitting privileges, he or she must also be knowledgeable about the patient's condition and treatment plan.

Source: Dentons

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