need help with staffing regs for LTC

U.S.A. Pennsylvania


Can anyone point me in the right direction?

How many RN per patient or shift?

Does their have to be a designated DON per facility (or acting DON)?

I think I know the answers, but would love to see the documentation before I make a friendly call to the dept of aging just to make sure.::imbar

Also, Is there a max number of hrs that a nurse can work per week or day?

Home Health Columnist / Guide


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Long term care facility regulations:

SNF: Nursing Services + minimum nursing staff ratios

(f) In addition to the director of nursing services, the following daily professional staff shall be available.

(1) The following minimum nursing staff ratios are required:

Census Day Evening Night

59 and under 1 RN 1 RN 1 RN or 1 LPN

60/150 1 RN 1 RN 1 RN

151/250 1 RN and 1 LPN, 1 RN and 1 LPN, 1 RN and 1 LPN

251/500 2 RNs 2 RNs 2 RNs

501/1,000 4 RNs 3 RNs 3 RNs

1,001/Upward 8 RNs 6 RNs 6 RNs

(2) When the facility designates an LPN as a nurse who is responsible for overseeing total nursing activities within the facility on the night tour of duty in facilities with a census of 59 or under, a registered nurse shall be on call and located within a 30-minute drive of the facility.

(g) There shall be at least one nursing staff employe on duty per 20 residents.

(h) At least two nursing service personnel shall be on duty.

(i) A minimum number of general nursing care hours shall be provided for each 24-hour period. The total number of hours of general nursing care provided in each 24-hour period shall, when totaled for the entire facility, be a minimum of 2.7 hours of direct resident care for each resident.

(j) Nursing personnel shall be provided on each resident floor.

(k) Weekly time schedules shall be maintained and shall indicate the number and classification of nursing personnel, including relief personnel, who worked on each tour of duty on each nursing unit.

(l) The Department may require an increase in the number of nursing personnel from the minimum requirements if specific situations in the facility--including, but not limited to, the physical or mental condition of residents, quality of nursing care administered, the location of residents, the location of the nursing station and location of the facility--indicate the departures as necessary for the welfare, health and safety of the residents.

Good Luck in your decision.

CoffeeRTC, BSN, RN

3,734 Posts

THANK YOU!!! Just what I was looking for, but couldn't seem to find. Although this wasn't in my facility, I just have a hard time seeing how this facility could get away with a part time DON and no real designee appointed in her place. I will pass this along to my friend.

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