26 Tex. Admin. Code § 554.1002 - Additional Nursing Services Staffing Requirements
(a) The ratio of licensed nurses to residents
must be sufficient to meet the needs of the residents.
(1) At a minimum, the facility must maintain
a ratio (for every 24-hour period) of one licensed nursing staff person for
each 20 residents or a minimum of .4 licensed-care hours per resident day. To
determine licensed-care hours per resident day, multiply the number of licensed
nurses by the number of hours they work in a single day and divide the product
by the number of residents in the facility. Three nurses working eight-hour
shifts is 24 hours, divided by 60 residents, equals .4 licensed-care hours per
resident day.
(2) Licensed nurses
who may be counted in the ratio include, but are not limited to, director of
nursing, assistant directors of nursing, staff development coordinators, charge
nurses, and medication/treatment nurses. These licensed nurses may be counted
subject to the limitations of paragraphs (3) and (4) of this
subsection.
(3) Staff, who also
have administrative duties not related to nursing, may be counted in the ratio
only to the degree of hours spent in nursing-related duties.
(4) If a multi-level facility (nursing
facility or Medicare SNF) has one director of nursing over the entire facility,
he may not be counted in the nursing ratio. A director of nursing for a single
distinct part may be counted in the ratio for the distinct part.
(b) A graduate vocational nurse
who has a temporary work permit must work under the direction of a licensed
vocational nurse, registered nurse, or licensed physician who is physically
present in the facility. The graduate nurse who has a temporary work permit
must work under the direction of a registered nurse until registration has been
achieved.
(c) If the facility uses
licensed temporary nursing personnel, the temporary personnel must have the
same qualifications that permanent facility employees do. If temporary
personnel are used for afternoon or night shifts, a full-time, licensed nurse
must be on call and immediately available by telephone. The on-call nurse must
be a registered nurse unless the facility has a current waiver from DHS and is
not required to provide daily RN coverage.
(d) Consultative pediatric nursing services
must be available to facility staff if the facility has a pediatric
resident.
Notes
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No prior version found.