I work in a LTAC in California that has 55 beds. Our ration is 4:1 for tele patients, and 5:1 for general patients. There are no resources nurses, the wound team will on work on 6 patients a day, and the charge nurse can only direct us (but not help with care), we have LVNs even though half of the patients have PICCs and most have IVs, and the CNAs can have 7 or 8:1. Are these staffing levels normal? Who sets the standards for LTAC staffing levels?