CMS published an announcement 7.20.09 describing regulatory changes that will impact standards for Medicare reimbursement starting 2010. The press release articulated the definition of “direct supervision” of an physician who is supervising nurse practitioners, clinical nurse specialists and/or certified nurse midwives as,”For services provided in the hospital, direct supervision means that the physician must be present in the hospital or on campus and immediately available to furnish assistance and direction throughout the performance of the procedure. For services furnished in an off-campus outpatient department, direct supervision means the physician must be present in the off-campus department and available to furnish assistance and direction throughout the performance of the procedure. In or out of the hospital, the physician need not be present in the room when the procedure is performed.” FEDERAL REGISTER July 20, 2009 Pgs. 35424 – 35425


Teamsters have filed an additional charge of Unfair Labor Practices with the National Labor Relations Board for alleged retaliatory conduct against employee Dale Slover, RN. Nurse Slover testified in May 2009 against the hospital and has filed a subsequent quality review report. See:

Dr. Howard Dean wants to speak directly with nurses about the role they, and doctors, must play during this critical phase in new healthcare system legislative process. The conference call will take place July 22, 2009, at 6:30 pm EST. In order to complete registration and review additional details related to the national conference call visit:

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