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    Designated representative may sign APN standard care arrangement on behalf of collaborating physician

    In the event you missed it, the administrative rules pertaining to the content of an advanced practice nurse standard care arrangement (“SCA”) were amended in February to permit signature of the SCA by a “designated representative” rather than by each collaborating physician in limited circumstances.

    As amended, OAC 4723-8-04(C)(1) provides that the SCA for a certified nurse midwife (“CNM”), certified nurse practitioner (“CNP”), and clinical nurse specialist (“CNS”) must include the signature of each nurse and each collaborating physician, or the physician’s designated representative, or each podiatrist with whom the CNM, CNP, or CNS primarily collaborates.

    The term “designated representative” is defined in the amended rule to mean, “… a physician who serves as the department or unit director or chair, within the same institution, organization, or facility department or unit, and within the same practice specialty, that the nurse practices, and with respect to whom the physician has executed a legal authorization to enter collaborating agreements on the physicians’ behalf.”

    The most current copy of the SCA, and any legal authorization signed by a physician appointing a designated representative must be retained and made available upon request at each site where the CNM, CNP, or CNS is practicing.

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