I am a case manager. We have patients that we are trying to place in sub-acute facilities. I do not have certification as a PRI assessor, but my manager does not feel that this is a problem. My understanding is that it is a state mandate that the assessor be duly certified. Am I wrong?
Nancy Brent replies:
Your role as case manager is an important one, and required credentials should be obtained and kept current. If you are not credentialed as required by state law, you may face some kind of penalty for acting in a role that requires you to be so, including a potential disciplinary action by the state board of nursing if a violation of the nurse practice act or rules exist.
Additionally, the patients you place into the sub-acute facilities may also suffer from your lack of certification, if it is required. They may be returned to your facility or placed in another facility similar to the one in which you work if they don’t meet requisites to be in the sub-acute facility. Obviously, at a minimum, this creates undue stress and anxiety in the patient/resident when he or she must be moved multiple times through no fault of his or her own.
A consultation with a nurse lawyer or lawyer in your state is essential in order to obtain the true status of this certification requirement. If you are not already credentialed as a nursing case manager, this additional certification would also be important. The American Nurses Credentialing Center (ANCC) offers the certification. Information on the process can be reviewed at www.nursecredentialing.org/cert/pdfs/casemgmtapp.pdf.
If not a already a member, consider joining the American Association of Managed Care Nurses (http://www.aamcn.org) as well. This resource would be helpful in ensuring that you have the requisite credentials needed to perform your role. The associations Professional Resource feature, which includes Standards of Practice for managed care nursing practice, might help convince your manager of your need for this credential. Clearly, though, whether or not your manager believes it is essential, your professional obligation is to have the necessary education and certifications to help you perform your job legally, ethically, and consistently with professional standards of practice.
Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.