Collaborative Practice Agreement
Center for Healthy Aging
(Formerly called the Geriatric Care Center)
This agreement covers care performed under the supervision of, Medical Director, Keith
Champney, MD in collaboration with Nurse Practitioners: Matthew Halverson, NP,
Dierdre Sweeney, NP, Judy Feener, NP, Barbara Blandford, NP, Diane Bucknill, NP. As
additional staff is hired they will be added to this agreement.
Scope of Practice:
As Nurse Practitioner’s (NP) are responsible for a broad range of primary care services to
residents in various nursing homes. A complete list of nursing homes is available on
Attachment A. This list may change with advance notice for the medical director.
The nurse practitioners will work in collaboration with Keith Champney, MD to provide
assessment and diagnosis of acute medical problems, on-going management of chronic
medical problems and health care maintenance. Based on the chief complaint, history of
the presenting illness, past medical history, predisposing factors and the physical examine
the nurse practitioner will formulate a differential diagnosis and treatment plan to
evaluate the patient including ordering diagnostic studies, lab studies, microbial cultures
and radiographic studies. The NP may also initiate consults to physical therapy,
occupational therapy, speech therapy, and psychiatric evaluations, in consultation with
Dr. Champney or covering physician in developing a plan of care.
In general, Dr. Champney will do the initial comprehensive assessment and initial plan of
care. The NP may do the initial evaluation prior to the physician comprehensive
examination.
Protocols for patient assessment and care will be the practice guidelines developed by the
American Medical Director’s Association and the American Geriatric Society, and other
appropriate authorities. Modifications will be made as a collaborative effort of the nurse
practitioner and the physician.
Procedures
Nurse Practitioners can independently perform selected procedures. These procedures
may include but not limited to all aspects of the physical examination, ear irrigation,
nebulizer treatments, simple wound closure, suture removal, simple wound debridement
and wound care.
Consultations
Physician consultation from Dr. Champney and/or covering physician is always available
to the Nurse Practitioner by telephone or by his physical presence in the nursing home.
The Nurse Practitioner will consult the physician in the following circumstances:
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Toxic, acutely ill or distressed or deteriorating patients.
Historical and/or clinical evidence for acute illness and/or complications.
Diagnosis is unclear and/or falls outside of the usual practice.
When consultation to other specialists is required
When terminal care commences.
When discharge to a hospital setting is considered.
Prescription Practice Guidelines are as follows:
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Nurse Practitioners may prescribe Schedule II-IV drugs
Nurse Practitioners may prescribe IV fluids/antibiotics
Nurse Practitioners may not order blood or blood products
Nurse Practitioners may not sign for Durable Medical Equipment (DME)
Nurse Practitioners may not arrange for direct admissions to the hospital.
Dr. Champney will periodically review medical records and verify physical findings of
the nurse practitioners. In general, this will occur when a patient has s significant change
in status or is acutely ill and when Dr. Champney does his bimonthly or quarterly review.
Any deficiencies will be discussed with the Nurse Practitioner.
In the event of Dr. Champney’s absence, another physician will be designated to provide
coverage. This collaborative arrangement shall be reviewed and updated regularly.
Signature/date below indicates agreement to the above protocols:
Keith J. Champney, MD
Matthew Halverson, NP
Dierdre Sweeney, NP
Judy Feener, NP
Barbara Blandford, NP
Diane Bucknill, NP
Attachment A
List of Skilled Nursing Facilities
Radius Health Care of Beverly
40 Heather Street
Beverly, MA
Radius Health Care of Danvers
56 Liberty Street
Danvers, MA
Hunt Nursing and Rehabilitation Center
80 Lindall Street
Danvers, MA
Blueberry Hilll Health Care
75 Brimball Avenue
Beverly, MA
Ledgewood Nursing Home
87 Herrick Street
Beverly, MA
Center for Healthy Aging
75 Lindall Street
Danvers, MA 01923
(Formerly called the Geriatric Care Center)