November 13, 2025
McKnight's Long-Term Care News
A moderate shift to include more advanced practice providers in nursing homes can lead to measurable improvements in patient outcomes, a new study has found.
Some 41% of nursing homes increased use of such providers — including nurse practitioners and physician assistants — between 2012 and 2019, according to researchers from the Perelman School of Medicine at the University of Pennsylvania.
In that same time period, 30-day rehospitalization rates of former acute-care patients decreased in facilities with a moderate increase in care by advanced practice providers. Published in the December issue of JAMDA, the study calculated the proportion of visits performed by advanced practice providers and physicians in more than 9,000 nursing homes.
About one-third of nursing homes (33%) increased APP visits by 5 to 40 percentage points, while 17% increased visits by those providers by 41 to 70 percentage points. But the lower rehospitalization effect was only statistically significant, showing a 1.1% drop, in the group with the less dramatic increases.
Nurse practitioners and physician assistants can conduct patient visits, manage acute and chronic conditions, prescribe medications and coordinate care.
“There are many advantages to having APPs in nursing homes,” study co-author Kira L. Ryskina, MD, said in PALTMed’s Caring for the Ages. “Compared to physicians, APPs who practice in nursing homes are more likely to focus their practice exclusively on nursing home work. Given the long-standing challenges of getting physicians into nursing homes, having the care provided by NPs and PAs may improve access to medical providers for nursing home patients. At the same time, we need to better understand what constitutes optimal care models for APPs and physicians who work in nursing homes.”
As a follow-up to the JAMDA study, Ryskina and her colleagues are launching a large national survey of nursing home clinicians to understand how they work collaboratively to co-manage patients.
“Understanding more about successful care models that reflect the changing workforce composition can inform education and training for nursing home providers, nursing home staffing practices, and reimbursement and regulatory policies,” she said.