According to an article by Nathan Shaw, Clinical Reimbursement Director of RB Health
Partners, appearing in a recent issue of Pulse, a publication for Florida’s LTC community, if the
attending physician is unavailable, a “physician extender” such as a Nurse Practitioner or
Physician Assistant can stroke the pen. However, care must be taken to determine that this person
does not have an indirect employment relationship with the facility. This can get dicey, but as
long as this person works for an entity other than the facility, that has an agreement with the
facility that solely involves the performance of “delegated physician tasks”, not “general nursing
services”, he or she can sign the certification.
