The requirements for RN staffing in LTC are mandated by OBRA (Federal Regulations) and state regulations. In California that would be Title 22. In California the RN staffing is based on the number of licensed beds (not on the number of pts.). Facilities with 99 or less beds are only required to have an RN awake on duty for 8 hours a day (usually on the day shift). The DON who must be an RN meets this requirement as long as she shows up to work everyday. On the DON, RN's days off she has to have an RN in the building in her place which is usually on the weekends and holidays or if she takes a day off, is sick or goes on vacations, etc. LTC over 100 beds and over must have an RN on each shift. If the LTC has a lot of IV's they will often staff the place round the clock with RN's b/c they are the only ones who can admin. IV meds unless they use an outside agency (which is very costly) to do this. The MDS nurse has to be an RN b/c the regulations state that an RN must conduct care plan conferences, sign off the MDS, etc. It depends on the number of pts. in regards to how much time the RN MDS nurse spends on administrative tasks and how much time they spend doing other things. If the RN-MDS is the only RN in the building she/he will meet the requirement for having an RN on duty. Since RN-MDS nurse performs assessments they are providing hands on care. Some of their hours can be included in staffing hours (like if they admin. IV meds, etc).
Would you like to comment?
staff RN's in LTC?
Here's your answer
:hatparty: 
