It depends on frequency of visits for the 40 patients. If each patient is one time a week, then that would be 40 visits for a week. However, some patients are 2-3x per week and others are every 2 weeks or only monthly if foley cath change or port flush. The agency probably needs at least 2 full-time RNs for a census like that because you would want to accomodate new admissions. Having an LPN or two is good also to go routine visits when the RNs are busy with intakes, RE, ROC.