Current through all regulations passed and filed through September 16, 2024
(A) Each nursing home shall arrange for the
services of an administrator who shall be present in the home to the extent
necessary for effectively managing the home and assuring that needs of the
residents are being met, but not less than sixteen hours during each calendar
week.
(B) Each nursing home shall:
(1) Employ a registered nurse who shall serve
as director of nursing:
(a) This requirement
may be met by two registered nurses who share the position as co-directors of
nursing.
(b) The director of
nursing or co-directors of nursing shall be on duty five days per week, eight
hours per day predominantly between the hours of six a.m. and six p.m. to
direct the provision of nursing services.
(c) The name of the director of nursing shall
be posted in a place easily accessible to residents, resident's families or
sponsors, and staff.
(2)
Designate another registered nurse in its employ to serve as acting director of
nursing in the event the director of nursing or co-directors of nursing are
absent from the nursing home due to illness, vacation or an emergency
situation. The name of the acting director of nursing shall be posted in a
place easily accessible to residents, residents' families or sponsors, and
staff.
(C) Each nursing
home shall have sufficient direct care staff on each shift to meet the needs of
the residents in an appropriate and timely manner and have the following
individuals provide a minimum daily average of two and one-half hours of direct
care and services per resident per day as follows:
(1) Nurse aides;
(2) Registered nurses, including registered
nurses who perform administrative and supervisory duties; and
(3) Licensed practical nurses, including
licensed practical nurses who perform administrative and supervisory
duties.
(D) Each nursing
home shall have a registered nurse on call whenever one is not on duty in the
home. The name of the registered nurse who is on call shall be posted in a
place easily accessible to residents, residents' families or sponsors, and
staff.
(E) Each nursing home shall
also have the following staff who are competent to perform the duties they are
assigned:
(1) Activities program staff as
required by paragraph (A) of rule
3701-17-09 of the Administrative
Code;
(2) Dietary staff as
required by paragraph (K) of rule
3701-17-18 of the Administrative
Code;
(3) Pharmacy services staff
as required by paragraph (A)(1) of rule
3701-17-17 of the Administrative
Code; and
(4) Social services staff
to assist the home in meeting the medically-related social service needs of the
residents and the requirements of rule
3701-17-09 of the Administrative
Code. Each nursing home with more than one hundred twenty beds shall employ, on
a full-time basis, one individual licensed as a social worker under Chapter
4757. of the Revised Code.
(F) In addition to complying with the
requirements in this rule, each nursing home shall
conduct an assessment of the residents admitted to the
facility, based on the residents' plans of care, to determine the staffing
level needed to provide, in a timely manner, adequate services and care
to meet the needs of the residents admitted to or retained in the nursing home
and to properly operate the dietary, housekeeping, laundry, and nursing home
maintenance facilities.
(1) The nursing home
shall determine the number and type of additional staff required based on the
services needing to be performed as identified in the plans of care required by
rule 3701-17-14 of the Administrative
Code, and authorized scopes of practice.
(2) The additional staff shall meet the
applicable qualifications of rules
3701-17-07 and
3701-17-07.1 of the
Administrative Code and provide services in accordance with applicable scopes
of practice.
(G)
With input from the
medical director and the director of nursing, the nursing home may adjust the
staffing levels based on the needs and acuity levels of the residents, but in
no event shall the staffing fail to meet the requirements of this
rule.
(H)
The nursing home shall establish a protocol for staff
coverage that includes coverage during vacations, emergency situations, and
long-term absences due to illness and unexpected absences and a contingency
plan for back-up coverage.
(I) A nursing home that is physically located
in the same building or on the same lot as
a licensed
residential
care facility
, or a home certified as a intermediate
care facility for individuals with intellectual disabilities that are
owned and operated by the same entity, or that provides an adult day care
program in the nursing home, may use staff from the nursing home to provide
services in the licensed
residential care facility, certified intermediate care
facility for individuals with intellectual disabilities, or adult day
care program or use appropriate and qualified staff from the
licensed residential care facility, certified intermediate
care facility for individuals with intellectual disabilities, or adult
day care program to meet part or all of the staffing requirements of this rule,
if all of the following criteria are met:
(1)
The nursing home at all times meets the minimal staffing levels required by
this rule. No staff simultaneously assigned to the staffing schedules of the
nursing home and the
residential care facility, certified intermediate care
facility for individuals with intellectual disabilities, or
adult day program shall be counted
towards meeting the staffing requirements of this rule;
(2) The other licensed
residential care facility or certified intermediate
care facility for individuals with intellectual disabilities, at all
times meet their applicable staffing level requirements. Shared nursing home
staff shall not be counted towards meeting the minimum staffing requirements
for the other licensed
residential care facility;
(3) Separate staffing schedules are
maintained for the nursing home, residential care facility, certified intermediate care facility for individuals with
intellectual disabilities, and adult day care program;
(4) The sharing of staff does not adversely
affect the quality and timeliness of meeting the care needs of the nursing
home,
residential care facility, or intermediate care
facility for individuals with intellectual disabilities residents and the
participants of the adult day care program;
(5) The nursing home, residential care
facility, intermediate care facility for individuals
with intellectual disabilities and adult day care program are within two
minutes or less response time from each other; and
(6) The monitoring of the call signal systems
in the nursing home and residential care facility are not disrupted and the use
of call signal systems is not limited to emergency use only.
(J) Each nursing home shall
maintain records necessary for the director to ascertain compliance with the
requirements of this rule.
(K)
Nothing in this rule shall be construed as authorizing an unlicensed individual
to provide services that require the individual to be licensed under Title 47
of the Revised Code or a health care professional to provide services outside
the professional's licensed scope of practice.
