Provision of medical care in nursing homes is a natural fit for physician-PA teams, as they care for their nursing home patients by alternating scheduled Medicare visits, sharing call, and sharing unscheduled medical visits. 

• The broad medical scope of their education prepares PAs to manage patients with multiple health problems, as so often is seen among nursing home residents.
• State laws permit physicians to delegate to PAs tasks and responsibilities that fall within the physician’s usual scope of practice.
• All state laws allow the physician and PA to practice in separate locations as long as the physician is available to the PA by telecommunication.
• Medicare allows PAs to personally perform every other scheduled visit to skilled nursing facility patients.  If a patient’s condition requires the provision of unscheduled medical visits, Medicare allows PAs to do the unscheduled visits without disrupting the already established schedule of alternating visits.
• Medicaid typically covers visits to non-skilled nursing facility patients.  Medicare’s skilled nursing facility rules generally apply to non-skilled facility patients.  If allowed by state law, PAs may substitute for physicians and deliver all scheduled and non-scheduled visits to non-skilled nursing facility patients.

AAPA Issue Brief: PAs in Geriatrics

Physician Practice in the Nursing Home: Collaboration with Nurse Practitioners and Physician Assistants
Annals of Long-Term Care, March 2006

Physician Assistants in Geriatric Medicine
Clinical Geriatrics, October 2007