Psychiatric Mental Health Nurse Practitioner (ABR & Casa Grande)

At Community Bridges, Inc. (CBI), a psychiatric practitioner is an integral specialty for our whole person approach in our integrated system of physical, psychiatric, and addiction services. The scope of practice of psychiatric practitioner in the inpatient setting will see adults 18 and older, all genders, all socio-economic backgrounds, complex medical history, and co-occurring psychiatric disorders.  Psychiatric practitioners at CBI will be expected to provide patient-centered, evidence-based care for patients as well as serve as patient advocates in all health-related matters, including the appropriate use of specialists, health services, and community resources. 

CBI will be looking for two PMNP's for the following shift and locations: 

Saturday - Sunday, 8:00am - 4:00pm to work at either our ABR or Casa Grande locations.

This document defines the skills, activities, and expertise that fall within the psychiatric practitioner’s scope of practice in the inpatient and outpatient setting.

General scope within their skills, competencies, and experience, licensed practitioner shall: 

• Complete Medical Practitioner Admission Orders and CON (for a Physician only) are completed and signed by the admitting medical practitioner, if the medical practitioner is not a physician, the practitioner will coordinate with the CPEC Medical Director to sign the CON within 24-hours of admission

• Completes a psychiatric evaluation (HPI) in its entirety and documents the evaluation in the patient file for each individual admitted to the inpatient behavioral health facility within 24-hours of admission. Reviews and acknowledges completed physical health H&P of each patient within 24-hours of admission.

• Reviews treatment plan and modifies to meet psychiatric, as well as, medical detoxification and physical health needs

• Reviews cases with RN and Transition Coordinator daily during rounds as part of discharge planning process

• Rounds completed daily in Inpatient between the hours of 0800 and 1600

• Documents daily rounds in progress note

• Monitors the treatment of physical health and/or coordination with PCP and other prescribers while in treatment.

• Initiates or recommends Consults and Coordination of Care

•    Coordinate with one another when discharging, admitting or transferring a patient to a different CBI program or level of care (or a facility outside the CBI system) and document in the medical record to ensure a smooth transition.

• Be available or will initiate coordination of care (doc to doc) promptly.  Will initiate or will direct staff to obtain collateral information.  Will review provided medical documentation and document findings. 

• Provides necessary documentation and treatment for patients under petition or court-ordered treatment including Special Treatment Plan and coordinates Tx with the outpatient team.

• Discharge Orders and plan

• Documents and signs full discharge orders and follow-up recommendations within 24-hours of discharge

• Documents review of discharge plan with the patient

• Pharmacotherapy:  Will prescribe appropriate pharmacotherapy for related psychiatric disorders, as well as, coordinated care for physical health, substance abuse treatment, and pain management.  Responsible prescribing practices will be adherent to accepted standards of care.  

• Maintain at least 80% of e-prescribing with a goal of 100%. 

• Addiction Medicine: Evidence in documentation of evaluating each patient for addiction medicine protocol prior to discharge.

• Suboxone Taper: Evidence in documentation of evaluating each patient for ongoing suboxone taper prior to discharge.

• Mental Health/Psychiatric Care: Evidence in documentation of evaluating each patient for ongoing mental health/psychiatric care prior to discharge.

• Physical Health: Evidence in documentation of evaluating each patient for ongoing physical health issues prior to discharge.

Universal:

• Complete orientation as directed by CBI, which includes shadowing another CBI practitioner prior to working with patients

• Complete a TB skin test prior to working with CBI patients and annually thereafter, TB skin test prior to working with CBI patients and annually thereafter to ensure professional is free from tuberculosis. Test results must be submitted to the Credentialing department annually.

• Obtains and maintains suboxone waiver for to treat the maximum number of patients for which the practitioner is eligible.

• Maintains necessary patient data logs as required when treating patients with buprenorphine to coordinate with the medical practice team and clinical team on caseload size.

• Provides evidence of CPR/First Aid prior to working with CBI patients and includes documentation of renewal every two years. Evidence of CPR/First Aid renewals must be submitted to the Credentialing Department. 

• Participate in quality management initiatives and correct any identified areas of deficiency within 72 hours; exceptions must be approved by the Director of Medical Practice in consultation with the CBI Medical Director. 

• Maintain a minimum 85% compliance with documentation requirements

• Not cancel patient appointments without prior notification to CBI

• Not refuse to see CBI patient(s) without approval from the medical director

• Adhere to the appointment scheduling protocols assigned by the medical director and monitored by the medical management team.

• Maintain a minimum of 85% patient satisfaction. If performance falls below 85%, practitioner will submit a plan of correction to the Medical Director.  If performance falls below 85% for two consecutive months, practitioner will be removed from the schedule and will not receive compensation during this time. 

• Maintain a minimum of 75% follow-up rate 

• Complete and document all medication assessments and informed consents by the end of the assigned shift or within 24 hours of seeing the patient. 

• Review the Controlled Substance Prescription Monitoring Program prior to treatment and coordinate care with other prescribing practitioners

• Utilize e-Prescribing for all patient prescriptions as established in the CBI electronic medical record

• Attend regular staffing and rounds on assigned patients; participate in the development of the patient’s treatment plan; provide clinical expertise for the treatment team for patient care; give appropriate direction and providing effective communication about patient care activities

• Support utilization review activities by clearly documenting admission medical necessity and continued stay necessity. This includes completion of certification of the need for Level I admissions or facilitating completion by a physician if the practitioner is a Nurse Practitioner or Physician Assistant

• Support utilization management activities by providing reviews when requested by payors

• Ensure necessary documentation and treatment for patients under petition or court order

• Promote collaboration patient care by communicating with referring and receiving professionals 

• Attend and actively participate in practitioner meetings; actively participate in any state, regulatory, or accreditation surveys; participate in peer review activities and performance improvement projects 

• Comply with agreed-upon work schedules to provide coverage at the facility and meet the clinical and business needs.  CBI maintains the right to schedule Medical Professional at any facility and will make every attempt to establish routine schedules.

• Give a minimum of 60 days’ notice for time off and will coordinate with peers to arrange for coverage for scheduled shifts. Time off requests will be sent to medicaltimeoff@cbridges.com and if employee will also submit request into CBI's current time and attendance system

• Notify Director of Medical Practice and Medical Director in the case of an emergency and inability to cover a scheduled shift

• Adhere to all policies and procedures established by CBI

• Other duties as assigned

Documentation:

Practitioners are expected to complete documentation within 24 hours of visit. Should documentation not be complete by allotted timeframe, practitioner is to notify the Director of Medical Practice. Should documentation not be complete with seven days of visit, compensation will be held until completion.

Training:

Practitioners may be asked to have new clinical staff of the same specialty or experience shadow them or be trained by them. Should the training impact patient care, adjustments will be made to practitioner schedules during training hours. 

 

Practitioner Education:

Practitioners will be expected to attend educational meetings as deemed appropriate for their specialty. Practitioners will be expected to participate in quarterly practitioner meetings. Should the practitioner be unable to participate in, a 24-hour notice will need to be given to the Director of Medical Practice.  Should an unexpected event occur, and the practitioner is unable to give notice. They will be expected to contact the Director of Medical Practice as soon as possible. Minimum of 3 quarterly meetings required per year. 

Integration:

As practitioners, it is important to recognize practice limitations and seek consultation with other healthcare professionals, when necessary, to provide optimal patient care. CBI offers behavioral health services, physical health services, and addiction medicine services, as well as partnerships outside of the agency. Practitioners are encouraged to utilize this care integration model to optimize patient care.