Q & A Section
Q: With Medicare cracking down on signed chart notes, I was wondering if you could clarify the protocol for nurse practitioners signing off on their chart notes. We have our nurse practitioners sign all of their chart notes but does a physician also need to sign off on every chart note, and if so, can he/she sign off with just initials or is a full signature with credentials required?
A: You need to check with your billing team to see how the NP's are billed. If they are billed on their own with their own Medicare NPI number, then the NP can sign it her- self. If you are billing any type of incident 2 or provider based where the physician number is used, then the physician has to sign as well, with full signature.
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Q: Does the NP have to work under the direction of a Physician? Are they *encouraged* to work under the direction of a Physician?
A: Not in Idaho. Beyond the Board of Nursing regulations, hospital privileges may require physician supervision to varying degrees in Idaho.
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Q: Can a NP work in a surgical setting? If a NP were to obtain employment with a cardiothoracic surgeon, could he or she assist in surgery?
A: Yes, however, there are criteria. The NP and PA licenses do not automatically grant this. The NP/PA must be credentialed by the hospital and demonstrate formal training and competence. Some hospitals require the NP to complete the RN First Assistant course. Others require training as a scrub.

Attention Healthy Connections Providers/AAP Members – Lead Screening Survey
The Department of Nursing at Boise State University, Medicaid and Friends of Children and Families, inc. Head start and Early Head start would like to know more about your practices and perceptions about lead screening of children enrolled in Medicaid. The Department of Nursing has awarded a grant to Dr Ingrid Brudenell, Karen Godard, RN,CRNP, MSN and Dr. Omair Shamim, Health and Nutrition Services Manager for Friends of Children and Families, Early Head Start and Head Start to assess health care providers’ perception of barriers, facilitators, and best practices for lead screening of children enrolled in Medicaid. Please look for a short survey that will be mailed in April or May. Please return the completed survey to the researchers. We greatly appreciate your feedback and ideas. If you have questions please contact Dr. Ingrid Brudenell, at 208-426- 1670 or emailibruden@boisestate.edu.

Attention ! All Medicaid Providers- Please respond to the Department of Nursing and Head start Lead Screening Survey which you have received. It is yellow and very important! If you would like another copy please contact Dr. Ingrid Brudenell at ibruden@boisestate.edu or 208-426-1670. We greatly appreciate your responses.
Thanks Ingrid