28 Pa. Code § 211.12 - Nursing services
(a)
[Reserved].
(b) There shall be a
full-time director of nursing services who shall be a qualified licensed
registered nurse.
(c) The director
of nursing services shall have, in writing, administrative authority,
responsibility and accountability for the functions and activities of the
nursing services personnel and shall serve only one facility in this
capacity.
(d) The director of
nursing services shall be responsible for:
(1) Standards of accepted nursing
practice.
(2) Nursing policy and
procedure manuals.
(3) Methods for
coordination of nursing services with other resident services.
(4) Recommendations for the number and
levels of nursing services personnel to be employed.
(5) General supervision, guidance and
assistance for a resident in implementing the resident 's personal health
program to assure that preventive measures, treatments, medications, diet and
other health services prescribed are properly carried out and
recorded.
(e) The
facility shall designate a charge nurse who is responsible for overseeing total
nursing activities within the facility on each tour of duty each day of the
week.
(f) [Reserved].
(f.1) In addition to the director of nursing
services , a facility shall provide all of the following:
(1) Nursing services personnel on each resident floor.
(2) Effective July 1, 2023, a minimum of 1
nurse aide per 12 residents during the day, 1 nurse aide per 12 residents
during the evening, and 1 nurse aide per 20 residents overnight.
(3) Effective July 1, 2024, a minimum of 1
nurse aide per 10 residents during the day, 1 nurse aide per 11 residents
during the evening, and 1 nurse aide per 15 residents overnight.
(4) Effective July 1, 2023, a minimum of 1
LPN per 25 residents during the day, 1 LPN per 30 residents during the evening,
and 1 LPN per 40 residents overnight.
(5) Effective July 1, 2023, a minimum of 1 RN per 250 residents
during all shifts.
(f.2)
To meet the requirements of subsections (f.1)(2) through (5):
(1) A facility may substitute an LPN or RN
for a nurse aide but may not substitute a nurse aide for an LPN or
RN.
(2) A facility may substitute
an RN for an LPN.
(3)
(i) A facility may not substitute an LPN for
an RN except as provided under subparagraph (ii).
(ii) A facility with a census of 59 or under
may substitute an LPN for an RN on the overnight shift only if an RN is on call
and located within a 30-minute drive of the
facility .
(g)
[Reserved].
(h)
[Reserved].
(i) A minimum number of
general nursing care hours shall be provided for each 24-hour period as
follows:
(1) Effective July 1, 2023, the total
number of hours of general nursing care provided in each 24-hour period shall,
when totaled for the entire facility , be a minimum of 2.87 hours of direct
resident care for each resident .
(2) Effective July 1, 2024, the total number of hours of general
nursing care provided in each 24-hour period shall, when totaled for the entire
facility , be a minimum of 3.2 hours of direct resident care for each resident .
(i.1) Only direct resident care provided by nursing services personnel may be
counted towards the total number of hours of general nursing care required
under subsection (i).
(j)
[Reserved].
(k)
[Reserved].
(l)
[Reserved].
Notes
The provisions of this § 211.12 amended under section 803
of the Health Care Facilities
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