Dialysis Staffing

CMS will not set any staff to patient ratio. (As stated in the new condition of coverage.) We brought this up to the CMS, during a conference, prior to the new regulations and they indicated that they would NOT get into that and set a certain ratio - probably because there is not enough staff out there to cover a set ratio.

Each state is different, you will need to check with the state board of nursing. Many of the states do NOT have ratios for dialysis clinics.
My clinic is 20 chairs= 4patients per PCT and 1 RN for 20 patients. We do not have a state regulation.

There is nothing illegal about that ratio as long as your state you work in does NOT have a set ratio, which would be RN to patient ratio and not PCT to pt ratio, since they are not covered under the state board of nursing regulations.
Like I just wrote, my clinic is 1 RN to 20 patients.

The best way to beat the system is to file complaints with the state, esrd network, and the FMC hotline. By doing this several times a week the area manager will be required to answer complaints that are annonymous, but still require an answer. Her or his time will be consumed with answering complaints, and not much more. When the problem is resolved the complaints cease. Everyone is happy, and can get back to work. I'll let you know if it works. So far it has. Managers hate paperwork.

DO NOT WORK FOR FREE!!!! that is exactly what you guys are doing and you shouldn't do it, you are all worth way more than that! I've been in dialysis for 10 years, first as a PCT, now and LPN about to begin the RN fast track program in Jan. I'm sure everyone who is working off the clock is working for a company who can DEFINITLEY afford to pay you. You need to all speak to the manager and if he/she does not do something about this situation, you need to move on up the ladder. This is something I would never condone, a previous poster was correct, if something happens it will not get paid for. If this doesn't get resolved I believe I would be changing jobs and work for an employer who appreciates the hard work. When I first began dialysis the ratio was 3:1, now it is 4:1. We have a dr. who is trying to get the company to factor in acuity levels when making staff assignments which would be GREAT as we have 3 patients who need a lift to transfer, several more in wheelchairs, and have one starting tomorrow who has a trach. Good luck, and please stop giving your precious time away.