Current through Reg. 49, No. 38; September 20, 2024
(a) A
CSU nursing supervisor, or designee, must adhere to nurse staffing requirements
delineated in §
510.41(c)(8) and
(j) of this title (relating to Facility
Functioning and Services) and the following parameters when determining minimum
staffing plans required by subsections (b) - (d) of this section.
(1) Staff included in the minimum staffing
plan must:
(A) always be physically available
while on duty; and
(B) have job
duties that do not prevent ongoing and consistent supervision of individuals
receiving crisis stabilization services.
(2) The minimum staffing plan must increase
or decrease based on CSU census and acuity, individual level of monitoring and
precautions, and developmental level, gender, age, and other individual needs
and characteristics of individuals receiving crisis stabilization
services.
(3) A staff member on
one-to-one supervision of an individual cannot be included in the CSU's minimum
staffing plan.
(b) The
minimum staffing plan includes:
(1) one
physician, preferably a psychiatrist, or physician-delegated PA or APRN, onsite
or at minimum immediately available through telecommunication or telephone 24
hours a day, seven days a week;
(2)
one LVN or one RN physically present and on duty 24 hours a day, seven days a
week, when an individual is present in the CSU;
(3) one RN available onsite within ten
minutes after being contacted by a staff member, if an RN is not physically
present and on duty when an individual is in the CSU;
(4) one QMHP-CS onsite from 8:00 a.m. to 5:00
p.m., Monday through Friday; and
(5) two UPs onsite 24 hours a day, seven days
a week.
(c) A nursing
supervisor or an RN charge nurse receiving clinical and administrative
consultation from the facility administrator and medical director or on-call
physician, APRN, or PA must be available, in person or by telephone, 24 hours a
day, seven days a week, to provide clinical oversight to CSU RNs, LVNs,
QMHP-CSs, and UPs.
(d) The nursing
supervisor or designee must develop and implement a written staffing plan
describing the number of RNs, LVNs, and UPs on each unit for each shift, in
accordance with subsections (a) and (b) of this section, that meet the
following requirements:
(1) The staffing plan
must be based on the census, needs, and characteristics of individuals, and
acuity of the CSU.
(2) The nursing
supervisor or designee must document the nursing supervisor's or designee's
determinations regarding the factors described in paragraph (1) of this
subsection:
(A) at the time the staffing plan
is developed; and
(B) when the
nursing supervisor or designee makes any revisions to the staffing plan based
on a change in such factors.
(3) A CSU nursing supervisor must retain the
staffing plan and the documentation required by paragraph (2) of this
subsection for two years.
(4) The
nursing supervisor or designee must revise the staffing plan, as
necessary.
