NH Regs Plus. Description of Federal Requirements    TOP    NEXT Federal regulations have almost no requirements for accelerating nursing staff according to the size of the facility or any other resident characteristics. Federal requirements call for a sufficient number of staff to accomplish the care plans, one RN in an 8 hour period largely during the day shift, one licensed nurse i. RN or an LPN on every tour of duty, and a Director of Nurses DON who is an RN. The only reference to size of the facility is the proviso that the DON may not count as the registered nurse on duty if the facility has 6. Federal law also requires that dedicated assistants with feeding not count as part of the nursing staff if the State has requirements as to the ratio of nursing staff to residents. Comparison of State Requirements    TOP    NEXTThirteen 1. States have no numerical ratios for nurse staffing, although some of these states require more licensed andor registered nursing presence than is required by federal regulation. The remaining States have established a required ratio of staff to residents. In those cases, the State almost always specifies the proportion of nursing time that must be fulfilled by licensed staff, and some States further differentiate between RN and other licensed staff. Typically, the State regulation specifies which licensed personnel cannot count towards the ratio usually the DON, and sometimes the ADON, the nurse educator, and other supervisory personnel. Maryland describes how to count ward clerk personnel into the overall ratio at 5. Some Statese. g. Find Resources About the Vermont 211 database The Vermont 211 database contains detailed descriptions of programs and services available to Vermonters that are. Georgia, specify that dining assistants not be counted in the ratio Vermont specified that activity staff and meal preparation staff do not count, whereas other States seem to take that for granted. Maine specifies that private duty nurses are not included in calculating the ratio. Some States specify adjustments that can be made to reduce the nursing staff to residents ratio if the residents attend other treatment programs during the daya circumstance more likely for residents in mental retardation or developmental disability facilities or special mental health programs. Indianarequires a ratio requirement for licensed staff only. Florida established a phase in process for bringing the staffing ratio up in 3 stages from 2. July 2. 00. 6. Some states simply specify the total nurse staff ratio, for example, 1. Louisiana, 2 hours per resident in Minnesota,  2. Delaware,  2. 7 hours per resident in Pennsylvania,  2. Mississippi, and 3. Nursing home regulations statefederalNH for 50 statesDC. Primary navigation links. Each entry expands to a submenu containing a structure of links disposed in one or more columns. Military Quick Links National Guard, Reserve, Active Duty ABA Military Pro Bono Project 321 N. Clark St. Chicago, IL 60654 3129885783 httpwww. California and Vermont. More commonly States specify the proportion of the hours that must be fulfilled by licensed personnel as opposed to CNAs for example, Iowa requires 2 hours per resident day, 2. The notion that 2. New Jersey is applied, then 2. Some States establish their instructions slightly differently for example, Georgia calls for 2 hours direct nursing per patient day, and states that for every 7 total nursing staff, 1 must be RN or licensed nurses. Sometimes States provide elaborate instructions for how to calculate the ratio, and also specify that it is the ratio of actual hour worked rather than hours scheduled that shall be counted. In a requirement that seems somewhat ambiguous, Kansas calls for a minimum of weekly average of 2. Several states require different ratios for different levels of care e. Windows Usb Driver Location more. DC8Qn0OXkAAspSx.jpg' alt='Nh Medicaid Waiver Programs By State' title='Nh Medicaid Waiver Programs By State' />SNF versus ICF or various levels recognized by the State. New Jersey offers a particularly complex formula whereby varying additional time is added to the basic nursing staff to resident ratio for each resident who needs any of a number of nursing procedures. At least 9 States specify or suggest the ratios per shift. New Mexico offers suggested ratios by shift and Illinois gives a desirable range for each shift, allowing for some facility variationi. Illinois staffing provisions are adjusted by case mix and quite complex, with additional variations for facilities with more than 2. Others state provide the specific ratio required for  each kind of personnel by each shift Connecticut, Michigan, Oklahoma, Oregon, and South Carolina. Some States merely refer to day, evening, and night shifts, whereas others actually provide the time periods for those shift Connecticut distinguishes between staffing from 7 a. South Carolina refers to 3 shifts, but then explains how to calculate ratios if the facility is using 1. Montana and West Virginia provide tables to indicate the minimum number of staff members of each type of training to be slotted into each shift. Montanas provisions are particularly elaborate. Several States add a caveat that notwithstanding the mandated ratios, the State may require additional staff. Summary+of+MLTC+programs.jpg' alt='Nh Medicaid Waiver Programs By State' title='Nh Medicaid Waiver Programs By State' />Provides an overview. Covers its history, organization, Physician Generals profile, events, birth and death certificate information and health topics AZ. Welcome to the home page for the Health Facilities Division of the Iowa Department of Inspections and Appeals. The Division is the designated state survey and. Massachusetts states that the minimum staffing patterns and nursing care hours as contained herein shall mean minimum, basic requirements. It anticipates that additional staff will be necessary in many facilities to provide adequate services to meet patient needs. Illinois anticipates occasional differences of opinion between facility staff and Department surveyors regarding the level of care an individual resident may require because the ratio is calculated based on assessments of level of care needs. The rules require that when such differences occur, the surveyor shall determine whether or not the resident is receiving appropriate care. If the resident is, the surveyor shall accept the facilitys level of care determination in determining the number of nursing hours to be provided by the facility. In Kansas, the licensing agency may require an increase in the number of nursing personnel above minimum levels under certain circumstances, including i location of resident rooms ii locations of nurses stations iii the acuity level of residents or iv that the health and safety needs of residents are not being met. In Nebraska, based upon the physical layout of the nursing facility, the licensing agency may increase the nursing care per resident ratio. The States also allow for lowering the required ratio. For example, in Maryland, facilities not participating in Medicare or Medicaid and with 4. If it discerns no hazard to residents, the Department may grant such exceptions based on information that includes  1 Size of the facility 2 Geographic location of the facility 3 Admission policies of the facility 4 Existing staffing pattern of the facility and 5 Number of volunteers in the activity program. Wisconsin enunciates a more permissive policy towards counting non nursing staff in nursing ratios. In Wisconsin, when determining staff time to count toward satisfaction of the minimum nursing service hours in this section, the following duties of nonnursing personnel, including ward clerks, may be included  a. Direct resident care, if the personnel have been appropriately trained to perform direct resident care duties b. Routine completion of medical records and census reports, including copying, transcribing, and filing c. Processing requests for diagnostic and consultative services, and arranging appointments with professional services d. Ordering routine diets and nourishments and e. Notifying staff and services of pending discharges. On the other hand, no services provided by volunteers may be counted toward satisfaction of nursing staff requirements. Table Comparing States   TOP Note If the States in this table are not hyper linked, their provisions do not appear to address the topic, and therefore, do not alter the Federal Regulatory scope. The Table summarizes content on Staffing Ratios by State with a link to each States specific language. Link to a downloadable PDF document containing all State requirements on Staffing Ratios. Staffing Ratios. State. Goes beyond Federal RegulationsSubjects Addressed How State Differs From or Expands On Federal Regulations. Alabama. No. Alabama regulations do not contain specific content for staff ratios. DHS PM 0. 7 Assets.