Trends in Nurse Practitioner and Physician Assistant Practice in Nursing Homes, 2000–2010

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To examine nurse practitioner (NP) and physician assistant (PA) practice in nursing homes (NHs) during 2000–2010.

Data Sources.

Data were derived from the Online Survey Certification and Reporting system and Medicare Part B claims (20 percent sample).


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.

Principal Findings.

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.


NP and PA scope-of-practice regulations impact their practice in NHs, not always as intended.

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