Do all LTC facilities have RN's?

The short answer is "yes." The long answer is longer and depends on state and ratios.

And also on the kind of facility. There are a lot of residential facilities, like "half-way" houses and supported (not assisted) living facilities that aren't required to have RNs on the premises, though depending on state regulation they may have to be supervised by an RN who may have several houses to oversee for general health issues for the residents, policies and procedures, staff training in CPR and med administration, and the like.

You can go to your state DPH website to get these questions answered.

Thank you guys for the quick responses

I would say yes. I worked on assisted living at a LTCF and the skilled nursing side had at least one RN each shift (they worked 12s, I did not)

My understanding is that a nurse does have to be on staff to supervise the LPNs and CNAs. As well as take MD orders and/or sign for orders. However they may work behind the scenes more and may not be as visible.

In most states, all LTC facilities must have at least one RN on duty for a minimum of 8 hours per day. This requirement is typically met via the director of nurses during weekdays, and the RN house supervisor on weekends.

This has been what I believed it to be while I was working. However, there usually must be an RN available on-call/reachable for shifts without the in-house RN.

So for 3-11 and/or 11-7, the facility might be staffed with floor RNs, or an RN supervisor. And still there would be someone else from nsg admin like DON, ADON, SD, UMs, other supervisors, as on-call for consultation or emergencies.

There's that tricky job responsibility about LPNs being able to do assessments (think admissions), and having staff able to do IVs that also plays into the equation. It all boils down to the pt case mix and facility needs for RNs 24 hours.

I never thought I would see the day, but many LTCs in my area are now pushing to have mostly RNs on staff with the CNAs.

To CoffeeRTC - are the facilities JACHO?

I've never heard the question, nor thought of it. I'm sure, as someone else said, that it varies from state to state. In my state you have to be a RN to 'pronounce', so a LTC facility better have a RN or two for that reason alone. In my facility there are numerous RN's, although many are doing case mgt., management, and currently there are only a few of us actually working the floor.