01/22/2026
Federal Bill Would Expand Clinical Authority in Skilled Nursing Facilities
New federal legislation would allow nurse practitioners, physician assistants, and clinical nurse specialists to perform required clinical assessments and oversee resident care in skilled nursing facilities without duplicative physician involvement. The Enhancing Skilled Nursing Facilities Act would remove federal rules that currently require a physician to repeat assessments already completed by advanced practice clinicians in order for Medicare or Medicaid payment, despite many states permitting these providers to work independently within their scope of practice.
LeadingAge has endorsed the bill, citing persistent workforce shortages across skilled nursing facilities, particularly among physicians and geriatricians. Supporters argue the change would reduce administrative burden, improve access to timely care, especially in rural and underserved areas, and help prevent avoidable hospitalizations by allowing qualified non-physician clinicians to serve as treating providers when physicians are not readily available.
Read more in McKnight’s Long-Term Care News.
