Current through Supplement No. 394, October, 2024
1. For
purposes of this section:
a. "Reside" means to
sleep and keep personal belongings; and
b. "Structure" means a building that is or
may be free standing. The existence of a walkway, tunnel, or other connecting
device on, above, or below ground is not effective to make one structure from
two or more component structures.
2. Each facility shall adopt a policy
specific to employee coverage for facility operations, including holidays,
weekends, on-call clinical team rotations, daytime and overnight hours. Policy
must address:
a. Designated employees
required for the facility on-call clinical team;
b. Number of qualified employees onsite to
sufficiently meet the needs of residents and respond to emergency
situations;
c. Evaluation of the
number of employees necessary to meet the age, developmental level, length of
treatment, and the service needs of the resident population;
d. Ability to ensure the safety of all
residents and allow adequate space to properly separate residents based on the
needs of the facility populations served;
e. Ability to schedule same gender or cross
gender supervision if indicated by resident treatment needs; and
f. Employees hired specific to the onsite
educational program may not be counted as direct care employees, treatment
coordinator employee, family engagement specialist, facility administrator, or
a clinical director during any time educational services are
provided.
3. Each
facility that operates more than one structure in which residents reside shall
count the total number of residents admitted to the facility, residing in all
structures collectively for purposes of determining the required number of
clinical and treatment employees to meet employee-to-resident ratios.
4. Each facility shall comply with the
following minimum employee-to-resident ratio requirements:
a. A rotating on-call clinical team must be
available twenty-four hours a day, seven days a week to meet the needs of
resident emergency and crisis situations. The on-call clinical team must
include at a minimum one nurse and one clinical employee;
b. No less than one half-time facility
administrator for a facility providing treatment for up to nine
residents;
c. No less than one
full-time facility administrator for a facility providing treatment for ten or
more residents;
d. No less than one
full-time clinical director;
e. No
less than one full-time nurse;
f.
No less than one full-time treatment coordinator employee for each ten
residents; and
g. No less than one
full-time family engagement specialist for each twenty residents or aftercare
clients.
5. During awake
hours each facility shall meet the standards of the facility's accrediting body
or the ratios set forth in this subsection, if the ratios set forth in this
subsection are greater than the employee-to-resident ratios set by the
accrediting body.
a. Two employees who are
qualified to provide direct care for one to twelve residents; and
b. One additional employee who is qualified
to provide direct care for every one through six additional residents
thereafter.
6. During
overnight hours each facility shall have:
a.
Awake employees at all times;
b.
Employee-to-resident ratio at a rate not less than:
(1) Two employees who are qualified to
provide direct care for one to twenty residents; and
(2) One additional employee who is qualified
to provide direct care for every one through ten additional residents
thereafter; and
c. A
policy that includes a requirement that an employee will check on residents
during overnight hours at a minimum of every fifteen minutes, and more
frequently if the acuity of the resident demands greater supervision. The
overnight checks must be:
(1) Documented and
available for review; and
(2)
Conducted in the least invasive manner to not disrupt the residents.
7. The facility shall
notify the department, in writing, if the minimum employee-to-resident ratios
are not met based on position vacancies. An interim plan to cover the employee
duties must be approved by the department.
General Authority: NDCC 50-11-03
Law Implemented: NDCC
50-11-02
