[CapeCodMermaid]

The regulations, in Massachusetts at least, says staffing must be 'adequate.' We could all argue all day about what is adequate and what is not. I've never worked in a building where is was part of the ADON or DON duties to pass meds. I've done it , of course, but it was never part of the job description.
The number of management type nurses depends on the size of the building and whether the residents are skilled or not.
My building has 135 beds, we have a DNS, ADNS, 2 MDS nurses, a Staff Development Coordinator and 3 nurse managers on the day shift. On the evening shift we usually have a free floating supervisor. The last building I was in had 120 beds with the same number of management types but fewer nurses on the floor. Every company is different...mostly it depends on your Medicare census

[pumpkin92356]

Where I work at you have DON, MDS, staff developer etc all on the day shift and we have one extra CNA total of 4 aides and LVN for 50 patients. What gripes me is that the swing shift does everything we do on day shift but we serve one extra meal that is lunch. The PM shift does just as many baths and during the dinner time one of them has to go to the main cafeteria because some of the residents about 5 prefer to dine independently and an aide has to be observing for choking assisting with serving food etc. This leaves 2 aides and one lVN to tackle the rest of the facility during dinner. We have 11 residents on bedalarms and 2 that yell out for the commode at least every hour. The staffing for pm shift needs at least one more aide like we have on dayshift.

[ingelein]

http://www.nccnhr.org/uploads/Harrin...sedJan2008.pdf

Above is the 2008 LTC staffing tables for the individual states , what is your opinion, are these safe staffing ratios?

[nightmare]

How do you calculate your hours per direct nursing care? Do you have some sort of assessment you do on each resident?