Nursing home surveyors may soon be taking a closer look at the delegation of certain physician tasks to physician assistants, nurse practitioners and clinical nurse specialists. In an April 10 letter to state survey agency directors (Ref: S&C-03-18), the Centers for Medicare & Medicaid Services clarifies various rules relating to physician delegation of tasks in skilled nursing facilities and nursing facilities. "PAs, NPs, and CNSs may provide medically necessary care to long term care residents, except in those few situations where the regulations require that the task be personally performed by a physician or when prohibited by State law or facility policy," CMS says. To see the memo, go to www.cms.gov/medicaid/ltcsp/sc0318.pdf. Lesson Learned: Long-term care facilities should make sure they have their acts together when it comes to delegating tasks to PAs, NPs and CNSs.