Director of Nurses Requirements for the State of Indiana
410 IAC 16.2-3.1-17 Nursing
services
Authority: IC 16-28-1-7; IC 16-28-1-12
Affected: IC 16-28-5-1
Sec. 17.
(b) The facility must provide
services by sufficient number of each of the
following types of personnel on a twenty-four (24)
hour basis to provide nursing care to all residents
in accordance with resident care plans:
(1) Except when waived under subsection
(f), the facility shall provide a licensed nurse
hour-to-resident ratio of five-tenths (.5) licensed nurse hour
per resident per day, averaged over a one (1) week period. The
hours worked by the director of nursing shall not be counted in
the staffing hours.
(4) Except as waived in subsection (f), the
facility must designate a registered nurse who has completed a
nursing management course with a clinical component or who has
at least one (1) year of nursing supervision in the past five
(5) years to serve as the director of nursing on a full-time
basis.
(c) The director of nursing will also
function in the following duties:
(1) Communication to the administrator and,
where appropriate, the physician, the status of the residents,
the occurrence of incidents, and accidents and unresolved
administrative problems of the nursing department.
(2) Plan for and direct nursing care
services in accordance with the physicians' orders and to meet
the needs of the residents.
(3) Provide for the training of nursing
staff.
(4) Supervise nursing personnel to assure
that preventive and restorative nursing procedures for each
resident are initiated and performed so as to attain and
maintain the highest practicable physical, mental, and
psychosocial well-being in accordance with the comprehensive
assessment and care plan.
(5) Assure that the clinical records are
maintained in accordance with the facility policies and
procedures and in compliance with this rule.
(d) The director of nursing shall have, in
writing, and shall exercise administrative authority,
responsibility, and accountability for nursing services within
the facility and shall serve only one (1) facility at a time in
this capacity, and confer with the administrator on the
evaluation of prospective residents to assure that only those
residents whose physical, mental, and psychosocial needs can be
met by the facility or through community resources are admitted
to and retained by the facility.
(e) The director of nursing may serve as a
charge nurse only when the facility has an average daily
occupancy of sixty (60) or fewer residents. These hours worked
may be counted toward staffing requirements.
(f) A facility may request a waiver from
either the requirement that a nursing facility provide a
registered nurse for at least eight (8) consecutive hours a day,
seven (7) days a week, or provide a registered nurse as the
director of nursing, as specified in subsection (b), if the
following conditions are met:
(1) The facility demonstrates to the
satisfaction of the state that the facility has been unable,
despite diligent efforts (including offering wages at the
community prevailing rate for nursing facilities), to recruit
appropriate personnel.
(2) The state determines that a waiver of
the requirement will not endanger the health or safety of
individuals staying in the facility.
(3) The state finds that, for any periods
in which registered nursing services are not available, a
registered nurse or physician is obligated to respond
immediately to telephone calls from the facility.
(4) A waiver granted under the conditions
listed in this subsection is subject to annual state review.
(5) Effective October 1, 1990, in granting
or renewing a waiver, a facility may be required by the state to
use other qualified, licensed personnel.
(6) The state agency granting a waiver of such
requirements provides notice of the waiver to the state long
term care ombudsman and the protection and advocacy system in
the state for the mentally ill and mentally retarded.
(7) The nursing facility that is granted
such a waiver by the state notifies residents of the facility.
(g) For purposes of IC 16-28-5-1, a breach
of:
(1) subsection (a), (c), or (d) is a
deficiency; and
(2) subsection (b), (e), or (f) is a
noncompliance.
(Indiana State Department of Health; 410
IAC 16.2-3.1-17; filed Jan 10, 1997, 4:00 p.m.: 20 IR 1541, eff
Apr 1, 1997; errata filed Apr 10, 1997, 12:15 p.m.: 20 IR 2414;
readopted filed Jul 11, 2001, 2:23 p.m.: 24 IR 4234) |
