Credential and Privilege Physicians Strategically for SNF Practice

Don’t overburden doctors with unnecessary paperwork and bureaucracy, long-term care regulatory experts urge.

This article was excerpted from an article originally published on the Credentialing Resource Center, July 26, 2017.

Although practitioners have come to expect rigorous credentialing when applying for hospital privileges, they don’t anticipate the same level of scrutiny in the long-term care arena and may therefore steer clear of nursing homes with an overly extensive onboarding process. “It can be difficult to recruit physicians to the long-term care setting in some markets, so we have to be mindful of what administrative burden we place on them,” says Stefanie Corbett, DHA, postacute care regulatory specialist at HCPro in Middleton, Massachusetts.

Given this historic trouble spot, experts recommend making the process as painless as possible for applicants without sacrificing important quality safeguards. Maintaining this delicate balance can be especially difficult for nursing homes affiliated with hospitals or health systems that seek to roll out their robust acute care credentialing approach across all locations.

“We’d love to be consistent across the continuum, but we do have to think practically about what the requirements are in different settings,” says Corbett. “Before we apply a blanket policy across the continuum, make sure that the expectations are practical for different settings.”

This can prove especially tricky when a hospital or health system shares its practitioners with an affiliated nursing home. The Joint Commission broaches this subject in an FAQ on its website, stating that a healthcare organization can either separate or integrate the medical staff credentialing and privileging processes of a hospital and a nursing center based in that facility as long as each entity meets the relevant requirements. If the organization opts for integration, the practitioner’s specific scope of practice in each setting must be clearly defined.

Despite The Joint Commission’s flexibility on this matter, Carol Cairns, CPMSM, CPCS, advisory consultant with The Greeley Company and president of PRO-CON, an Illinois-based medical staff services consulting group, advises against deploying disparate sets of standards for practitioners who work in multiple settings. Take, for example, a health system with hospitals and SNFs and affiliated physicians who practice in both environments. The organization could ensure that, by virtue of being credentialed in the acute care setting, such practitioners automatically meet whatever credentialing standards exist for the lower-acuity nursing facilities. If, however, the system doesn’t require all practitioners who work in its nursing homes to maintain acute care privileges (e.g., at one of its locations and/or a local hospital), then it might make sense to establish a second, less stringent pathway to vet those licensed independent practitioners who practice solely in nonacute environments.