(10) Personnel.
(a) Job descriptions. Written job
descriptions shall be developed for each category of personnel, to include
qualifications, lines of authority and specific duty assignments.
(b) Employee records. Current employee
records shall be maintained and shall include a resume of each employee's
training and experience, evidence of current licensure or registration where
required by law, health records, records of in-service training and ongoing
education, and the employee's name, address and Social Security
number.
(c) Staffing requirements.
1. The facility shall have adequate personnel
to meet the needs of the patients on a twenty-four (24) hour basis. The number
and classification of personnel required shall be based on the number of
patients and the amount and kind of personal care, nursing care, supervision
and program needed to meet the needs of the patients as determined by medical
orders and by services required by this administrative regulation.
2. When the staff to patient ratio does not
meet the needs of the patients, the Division for Licensing and Regulation shall
determine and inform the administrator in writing how many additional personnel
are to be added and of what job classification and shall give the basis for
this determination.
3. A
responsible staff member shall be on duty and awake at all times to assure
prompt, appropriate action in cases of injury, illness, fire or other
emergencies.
4. Volunteers shall
not be counted to make up minimum staffing requirements.
5. The facility shall have a director of
nursing service who is a registered nurse and who works full time during the
day, and who devotes full time to the nursing service of the facility. If the
director of nursing has administrative responsibility for the facility, there
shall be an assistant director of nursing, so that there shall be the
equivalent of a full-time director of nursing service. The director of nursing
shall be trained or experienced in areas of nursing service, administration,
rehabilitation nursing, psychiatric or geriatric nursing. The director of the
nursing service shall be responsible for:
a.
Developing and maintaining nursing service objectives, standards of nursing
practice, nursing procedure manuals, and written job descriptions for each
level of nursing personnel.
b.
Recommending to the administrator the number and levels of nursing personnel to
be employed, participating in their recruitment and selection and recommending
termination of employment when necessary.
c. Assigning and supervising all levels of
nursing personnel.
d. Participating
in planning and budgeting for nursing care.
e. Participating in the development and
implementation of patient care policies.
f. Coordinating nursing services with other
patient care services.
g. Planning
and conducting orientation programs for new nursing personnel and continuing
in-service education for all nursing personnel.
h. Participating in the screening of
prospective patients in terms of required nursing services and nursing skills
available.
i. Assuring that a
written monthly assessment of the patient's general condition is
completed.
j. Assuring that a
nursing care plan shall be established for each patient and that his plan shall
be reviewed and modified as necessary.
k. Assuring that registered nurses, licensed
practical nurses, nurses' aides and orderlies are assigned duties consistent
with their training and experience.
I. Assuring that a monthly review of each
patient's medications is completed and notifying the physician when changes are
appropriate.
6.
Supervising nurse. Nursing care shall be provided by or under the direction of
a full-time registered nurse. The supervising nurse may be the director of
nursing or the assistant director of nursing and shall be trained or
experienced in the areas of nursing administration and supervision,
rehabilitative nursing, psychiatric or geriatric nursing. The supervising nurse
shall make daily rounds to all nursing units performing such functions as
visiting each patient, and reviewing medical records, medication cards, patient
care plans, and staff assignments, and whenever possible accompanying
physicians when visiting patients.
7. Charge nurse. There shall be at least one
(1) registered nurse or licensed practical nurse on duty at all times who is
responsible for the nursing care of patients during her tour of duty. When a
licensed practical nurse is on duty, a registered nurse shall be on
call.
8. Pharmacist. The facility
shall retain a licensed pharmacist on a full-time, part-time or consultant
basis to direct pharmaceutical services.
9. Therapists.
a. If rehabilitative services beyond
rehabilitative nursing care are offered, whether directly or through
cooperative arrangements with agencies that offer therapeutic services, these
services shall be provided or supervised by qualified therapists to include
licensed physical therapists, speech pathologists and occupational
therapists.
b. When supervision is
less than full time, it shall be provided on a planned basis and shall be
frequent enough, in relation to the staff therapist's training and experience,
to assure sufficient review of individual treatment plans and
progress.
c. In a facility with an
organized rehabilitation service using a multidisciplinary team approach to
meet all the needs of the patient, and where all therapists' services are
administered under the direct supervision of a physician qualified in physical
medicine who will determine the goals and limits of the therapists' work, and
prescribes modalities and frequency of therapy, persons with qualifications
other than those described in subsection (9)(c)9a of this section may be
assigned duties appropriate to their training and experience.
10. Dietary. Each facility shall
have a full-time person designated by the administrator, responsible for the
total food service operation of the facility and on duty a minimum of
thirty-five (35) hours each week.
11. Each facility shall designate a person
for the following areas who will be responsible for:
a. Medical records;
b. Arranging for social services;
and
c. Developing and implementing
the activities program and therapeutic recreation.
12. Supportive personnel, consultants,
assistants and volunteers shall be supervised and shall function within the
policies and procedures of the facility.
(d) Health requirements. No employee
contracting an infectious disease shall appear at work until the infectious
disease can no longer be transmitted.
(e) Orientation program. The facility shall
conduct an orientation program for all new employees to include review of all
facility policies (that relate to the duties of their respective jobs),
services and emergency and disaster procedures.
(f) In-service training.
1. All employees shall receive in-service
training and ongoing education to correspond with the duties of their
respective jobs.
2. All nursing
personnel shall receive in-service or continuing education programs at least
quarterly.