staff RN's in LTC?

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Specializes in med/surg, ortho, rehab, ltc.

I would greatly appreciate any input from anyone familiar with LTC and Medicare regs. Specifically, are there a minimum number of hours of Direct RN care a nursing home must provide per day? I am returning to nursing after a couple of years off. I'd love to work pt 3 3-11 shifts as a staff RN in LTC. I had an interview at a nursing home today. The DON said she is only required to provide 8 hours of RN level care per day. Does this mean direct care? Or does the Assist DON and MDS RN

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I would greatly appreciate any input from anyone familiar with LTC and Medicare regs. Specifically, are there a minimum number of hours of Direct RN care a nursing home must provide per day? I am returning to nursing after a couple of years off. I'd love to work pt 3 3-11 shifts as a staff RN in LTC. I had an interview at a nursing home today. The DON said she is only required to provide 8 hours of RN level care per day. Does this mean direct care? Or does the Assist DON and MDS RN

I am interested in the answers you get. My goal is to become an RN yet I would like to work in an assisted living home, or with the elderly in an ltc setting... the problem is I have been told lately nursing homes "never" hire RN's.. is that true ?

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The requirements for RN staffing in LTC are mandated by OBRA (Federal Regulations) and state regulations. In California that would be Title 22. In California the RN staffing is based on the number of licensed beds (not on the number of pts.). Facilities with 99 or less beds are only required to have an RN awake on duty for 8 hours a day (usually on the day shift). The DON who must be an RN meets this requirement as long as she shows up to work everyday. On the DON, RN's days off she has to have an RN in the building in her place which is usually on the weekends and holidays or if she takes a day off, is sick or goes on vacations, etc. LTC over 100 beds and over must have an RN on each shift. If the LTC has a lot of IV's they will often staff the place round the clock with RN's b/c they are the only ones who can admin. IV meds unless they use an outside agency (which is very costly) to do this. The MDS nurse has to be an RN b/c the regulations state that an RN must conduct care plan conferences, sign off the MDS, etc. It depends on the number of pts. in regards to how much time the RN MDS nurse spends on administrative tasks and how much time they spend doing other things. If the RN-MDS is the only RN in the building she/he will meet the requirement for having an RN on duty. Since RN-MDS nurse performs assessments they are providing hands on care. Some of their hours can be included in staffing hours (like if they admin. IV meds, etc). :rolleyes:

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In assisted living sometimes they utilize LPN's & RN's in an adminstrative capacity. In California and Florida they have a serious shortage of RN's in the nursing home, they need them to fill the position of DON, ADON, MDS Coordinator and charge nurses. The question with LTC is not If you will find work but WHERE. :)

I am interested in the answers you get. My goal is to become an RN yet I would like to work in an assisted living home, or with the elderly in an ltc setting... the problem is I have been told lately nursing homes "never" hire RN's.. is that true ?
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In Louisiana An Rn Is Required For A Minimum Of 8 Hrs Daily,,,unless You Have A Snf Unit With Iv's And Pushes Etc Or Anything That By Law Requires An Rn License....the Awake Part Jogs My Memory We Had An Rn Who Came In And Slept The Whole Time....lpn S Would Start Ivs And Wake Him Up If There Was An Emergency With One Of "his Pts" Other Emergencies Were Handled By Lpn On Duty...i Don't Necessaryily Think That This Was Legal And I Am Sure That State Didn't Know Anything About It....

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That's good...... I have always had a very soft spot for the elderly my entire life. As a child I used to volunteer at a nursing home. :)

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Specializes in ICU, PICC Nurse, Nursing Supervisor.

In the LTC center /alzheimers center I work at there is more RN's than LVN's. :p

I would greatly appreciate any input from anyone familiar with LTC and Medicare regs. Specifically, are there a minimum number of hours of Direct RN care a nursing home must provide per day? I am returning to nursing after a couple of years off. I'd love to work pt 3 3-11 shifts as a staff RN in LTC. I had an interview at a nursing home today. The DON said she is only required to provide 8 hours of RN level care per day. Does this mean direct care? Or does the Assist DON and MDS RN
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Specializes in med/surg, ortho, rehab, ltc.

Many thanks everybody.

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Does anyone know about the laws in AL??

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In PA there must be an RN in the building at all times. I have more RNs than LPNs.

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