Cms guidelines for DON

[imjstme]

So, the CMS guidelines for DON state that the DON may serve as the charge nurse when the average daily occupancy is 60 or lower.

What does this even mean?

I've served as charge many times and out census is higher than 60. It's never been brought to me as an issue though.

Also, the facility must have an RN for 8 "consecutive hours" 7 days a week... What about clocking out for lunch? Work 6-10, clock our for lunch and then work 1030 -2...Wouldn't that be non-consecutive?

The person I consult about rules of the state will never give me a clear answer on anything. So, I'm trying to find answers elsewhere.

[NurseBlaq]

I take it to mean if there are 60 or less residents at your facility's daily capacity, the DON may also double as the charge nurse. You wouldn't hear if this as most LTC facilites have more than 60 residents at any given time.

As for the 8 consecutive hours thing, clocking out for lunch is a company policy. Many have this, however, the charge nurse is usually barred from leaving the facility during lunch. Therefore, there's technically always an RN on duty. As a backup, the DON and sometimes other RN management usually relive the charge during those 30 minutes. If you're concerned about it, make sure a second RN is on duty so they can relieve one another during those 30 minutes and create a policy where they can't both be clocked out at the same time. That way you're always covered.

Just my $0.02.