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Are Nursing Homes Required To Have Certain Numbers Of Staff?

“Are nursing homes required to have certain numbers of staff”

-Edward, Highland Park, IL

Nursing Homes Required To Have Certain Numbers Of StaffIllinois does not require a specific staff to patient ratio for Illinois nursing home facilities.  The responsibility lies on each facility to determine the staffing needs to meet the needs of its residents.  (Section 300.1230 – Staffing)  The Administrative Code requires that a sufficient number of staff remain on duty for all hours of the day to provide services that meet the total needs of the residents.  (Administrative Code Part 300 – Skilled Nursing and Intermediate Care Facilities Code)

Staffing is based on the needs of the residents and is determined by determining the number of hours of nursing time each resident needs on each shift of the day.  This determination must be made separately for both licensed and unlicensed nursing personnel.  The number and categories of personnel that should be provided is based on:

  • Number of residents
  • Amount and kind of care required to meet the needs of all residents at all times
  • Size, physical condition, and layout of building including proximity to resident rooms
  •  Medical orders (Section 300.1230 – Staffing)

The Skilled Nursing and Intermediate Care Facilities Code provides examples for how to compute staffing needs for a 100 bed Skilled Nursing Facility, based on the considerations listed above (see Resources below).

The facility must provide the necessary care and services to attain or maintain the highest level of physical, mental, and psychological well-being of the residents.  (Section 300.1210 – General Requirements for Nursing and Personal Care)

Each facility must have a director of nursing services (DON) who is a registered nurse and is a full-time employee on duty a minimum of 36 hours, four days a week, with at least 50% of their hours scheduled between 7 A.M. and 7 P.M.  In facilities with 100 or more occupied beds, there must also be an assistant director of nursing (ADON), on duty a minimum of 36 hours, four days a week.  For all shifts, there must be a licensed nurse designated as being in charge of nursing services when neither the DON nor the ADON are on duty.  The facility must also have a minimum of one staff member awake and ready at all times.

Resources:

Illinois Nursing Home Care Act

Administrative Code – Part 300 – Skilled Nursing and Intermediate Care Facilities Code

Section 300.1210 – General Requirements for Nursing and Personal Care

Section 300.1230 – Staffing – (p) – Example of Staffing Calculations

A)        Total Minimum Hours of Care Needed

Level of Care

# of Residents

Total Hrs. Needed/Day Per Resident

Total Hrs. Needed/Day Per Facility

Skilled

25

[times]

2.5

=

62.5

General ICF

50

[times]

1.7

=

85.0

Light ICF

25

[times]

1.0

=

25.0

Total hours needed

172.5

B)        Minimum Total Hours Needed Per Shift

Shift

Total Hrs. Per Day

Minimum Percent

Total Hrs. Needed

7-3

172.5

[times]

45%

77.6

3-11

172.5

[times]

35%

60.4

11-7

172.5

[times]

20%

34.5

100%

172.5

C)        Licensed Nurse Coverage

Shift

Minimum Hrs. Per Shift

Minimum Percent

Minimum Nurse Hours Required

7-3

77.6

[times]

20%

15.5

3-11

60.4

[times]

20%

12.1

11-7

34.5

[times]

20%

6.9

D)        Licensed Nurses Required

Shift

Minimum Nurse Hrs. Required

Hrs. Worked Per Shift

# of Nurses Needed

7-3

15.5

[divided by]

8

=

1.93 (2)

3-11

12.1

[divided by]

8

=

1.51 (1.5)

11-7

6.9

[divided by]

8

=

0.86 (1)

E)         Nurse Aide/Orderly Coverage

Shift

Minimum Nurse Hrs. Required

Hrs. Worked Per Shift

# of Nurses Needed

7-3

77.6

[minus]

15.6

=

        62.1

3-11

60.4

[minus]

12.1

=

        48.3

11-7

34.5

[minus]

6.9

=

        27.6

F)         Nurse Aides/Orderlies Required

Related Nursing Homes Abuse Blog Entries:

Nurses Admit To Problems At Nursing Homes

High Staff Turnover Rates Plague Most Nursing Homes

A Recipe For Danger: Nursing Shortage Could Reach 1M By 2020 

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  • Shon Ingram

    Excellent article. Georgia requires a 2.5 ratio based on census. For a long time I have been a proponant of staffing by acuity rather than census. It just makes more sense since those with issues require more care.

  • your numbers are a bunch of bull you cannot leave it up to an administartor to say how many staff you need because his concern is about making money; someone sitting behind a desk is not bustting their tails off to see what that patient really and how best to take care of them. one nurse  and one cna can not taken care of 49 patients at night by themselves and give the care they need potential for staff to hurt themselves and cause harm to the patient

  • First I am a retired  LPN and proud to be a nurse. However my concern is fthe many patients in t he nursing homes whom someone likes to have as litting staffing as possible 48 to 2 staff, 1 LPN and 1 CNA, with bed checks, med pass, prns to give blood pressures ;blood sugars and of course the unexpected or a  patient wants to talk to you, you reply I don’t have time for this which you cann’t do but you may be thinking because someone wants to talk too and you get father behind but who cares the administrator,who wants more money,lawyer sitting behind the desk or heaven  forbid Obama and congress who have no clue. Yes this is a  susituation. Census can not tell from one night to the next what the patient will require

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