In a designated
Ventilator Assisted Program unit, the following staffing requirements apply:
A licensed nurse must be on duty 24 hours
a day, seven days a week.
(i) A registered
nurse must be on duty at least 16 hours a day.
(ii) Other types of licensed nurses may cover
the other 8 hours in the 24-hour period.
(B) The facility shall not assign more than
15 Ventilator Assisted Program residents per Ventilator Assisted Program
trained licensed nurse.
hours do not include the Resident Care Manager functions and oversight of care
plans for non-Ventilator Assisted Program residents.
(b) The facility shall not assign more than
12 Ventilator Assisted Program residents per licensed respiratory therapist and
must have an on-site, licensed respiratory therapist 24 hours a day, seven days
a week in the designated area.
Certified Nursing Assistants (CNA). The facility must have Ventilator Assisted
Program trained CNAs in the ratios noted below:
(A) Day Shift: 1 nursing assistant per 6
(B) Evening Shift: 1
nursing assistant per 9 residents
(C) Night Shift: 1 nursing assistant per 12
(d) At all
times the facility must have at least two Ventilator Assisted Program trained
staff present within the designated area.
(e) The facility shall ensure the 24 hour
on-call availability of the Medical Director or designated physician for the
Ventilator Assisted Program in the event the resident's primary care physician
is not available.
(f) The facility
shall ensure the availability of a licensed pulmonologist on sight in the
designated unit at least one time per week and ensure the on-call availability
of a pulmonologist.
(g) Within this
unit, staffing levels must be sufficient to meet the scheduled and unscheduled
needs of residents.
facility must maintain separate staffing records posted within the unit for the
nursing and respiratory staff responsible for the ventilator dependent
(i) The facility shall
report monthly, to the Department, their staffing levels for first year of
their endorsement, or until the Department has found them to be sufficient in
maintaining required staffing levels, whichever date comes later.
In an emergency situation, as defined in
411-090-0110, when trained CNA staff are not available to provide services, the
facility may assign staff who have not completed the required training in
accordance with this rule. The emergency must be documented and immediately
reported to relevant APD local office staff and the Department. The
documentation must address:
(A) The nature of
(B) How long the
(C) The names and
positions of staff that provided coverage.
(D) The contingency plan.