Problem: CMS Conditions of Participation require that a licensed physician must see and review the care of the residents of a nursing facility at least once every 30 days for the first go days after admission, and at least once every 60 days thereafter. Once the physician has completed the initial comprehensive visit in the nursing facility, the physician may then delegate alternate visits to an advanced practice provider such as a physician assistant (PA) or nurse practitioner (NP). During a site visit survey of a skilled nursing facility (SNF), the surveyors found that the medical director, a physician, has taken a six-month leave of absence, delegating responsibility for the care of the SNE residents to another physician. During this time, the covering physician delegated all the new resident evaluations to the medical director's nurse practitioner to formally admit them to the facility and to review and approve their medications, treatments, and care planning. The covering physician is only seeing residents who were admitted prior to the medical director's leave of absence to monitor and approve the residents ongoing treatment and care. The surveyors find that this practice does not comply with the Conditions of Participation and the facility was cited. Need Assignment Help?