Current through Register Vol. 50, No. 9, September 20, 2024
A. The
nursing facility shall provide a sufficient number of nursing service personnel
consisting of registered nurses, licensed practical nurses, medication
attendants certified, and certified nurse aides to provide nursing care to all
residents in accordance with resident care plans 24 hours per day.
1. At a minimum, the nursing facility shall
provide 2.35 hours of care per patient per day. The director of nursing (DON),
the assistant director of nursing (ADON), and nursing department directors may
be counted towards the minimum staffing requirements only for the time spent on
the shift providing direct and/or hands on resident care services. A maximum of
eight ward clerk hours per day can be utilized in the calculation of care hours
per resident day.
2. The facility
shall post the following information on a daily basis:
a. the facility name;
b. the current date;
c. the resident census; and
d. the total number and the actual hours
worked by the following categories of licensed and unlicensed nursing staff
directly responsible for resident care per shift:
i. registered nurses;
ii. licensed practical nurses; and
iii. certified nurse aides.
3. The facility shall
post the nurse staffing data specified above on a daily basis at the beginning
of each shift. The data shall be posted:
a.
in a clear and readable format; and
b. in a prominent place readily accessible to
residents and visitors.
4. The facility shall, upon oral or written
request, make nurse staffing data available to the public for review at a cost
not to exceed the community standard.
5. Nursing service personnel shall be
assigned duties consistent with their education and experience, and based on
the characteristics of the resident census and acuity, and nursing skills
required to provide care to the residents.
6. Licensed nurse coverage shall be provided
24 hours per day in the nursing facility. The facility shall develop a policy
regarding the nursing services provided by licensed nurses. The policy shall be
developed in consideration of the following:
a. the physical layout of the nursing
facility;
b. the acuity of the
residents; and
c. the resident
census.
B.
Director of Nursing
1. The nursing facility
shall designate a registered nurse to serve as the director of nursing services
on a fulltime basis during the day-tour of duty.
2. The director of nursing services may serve
as charge nurse only when the nursing facility has an average daily occupancy
of 60 or fewer residents.
3. The
director of nursing services shall have responsibilities which include, but are
not limited to:
a. supervising the functions,
activities, and training of all nursing personnel;
b. developing and maintaining standard
nursing practice, nursing policy and procedure manuals and written job
descriptions for each level of nursing personnel;
c. coordinating nursing services with other
resident services;
d. designating
the charge nurses pursuant to this section;
e. ensuring that duties of all nursing
personnel are clearly defined and assigned in accordance with the level of
education, preparation, experience, and licensure; and
f. supervision of documentation by nursing
personnel.
C.
If the director of nursing services has non-nursing administrative
responsibilities for the nursing facility on a regular basis, there shall be
another registered nurse designated to assist in providing direction of care
delivery to residents.
D. The
director of nursing may serve in such capacity for only one nursing
facility.
E. Charge Nurse. A
registered nurse, or a qualified licensed practical nurse, shall be designated
as charge nurse by the DON for each tour of duty and is responsible for
supervision of the total nursing activities in the nursing facility during each
tour of duty.
1. The charge nurse delegates
responsibility to nursing personnel for the direct nursing care of specific
residents during each tour of duty on the basis of staff qualifications,
size/physical layout of the nursing facility, characteristics of resident
census and acuity, and emotional, social, and nursing care needs of the
residents.
F. In building
complexes or multi story buildings, each building or floor housing residents
shall be considered a separate nursing unit and separately staffed, exclusive
of the director of nursing.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
40:2009.1-2116.
