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Final ruling allows advanced practice RNs (APRNs) on hospital medical staff, but the devil is in the details. Citing its intent to eliminate burdensome conditions of participation, the Centers for Medicare and Medicaid Services (CMS) has issued a final ruling that broadens the concept of medical staff to include APRNs. The CMS considered almost 2,000 public comments, as well as the October 2010 Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health. Although most comments supported the change that would broaden the definition of medical staff, there were a "significant number" who were opposed. And although the rule change is a step forward, it still confers power on the medical staff-that is, physicians-to examine credentials and make recommendations on medical staff membership. Read the details of this rule change and others at