Nursing Services Requirements for the State of New Mexico
7.9.2.50 NURSING SERVICES:
A. DEFINITIONS:
(1) Nursing personnel: means nurses,
nurse aides, nursing assistants, and orderlies.
(2) Ward clerk: means an employee who
performs clerical duties of the nursing personnel.
B. DIRECTOR OF NURSING SERVICES IN
SKILLED CARE AND INTERMEDIATE CARE FACILITIES:
(1) Staffing requirement: Every skilled
care facility and every intermediate care facility shall
employ a full-time director of nursing services who may also
serve as a charge nurse. The director of nursing services
shall work only on the day shift except as in an emergency
or required for the proper supervision of nursing personnel.
(2) Qualifications: The director of
nursing services shall:
(a) Be a registered or licensed
practical nurse; and
(b) Be trained or experienced in areas
such as nursing service administration, restorative nursing,
psychiatric nursing, or geriatric nursing.
(3) Duties: The director of nursing
services shall be responsible for:
(a) Supervising the functions,
activities and training of the nursing personnel;
(b) Developing and maintaining standard
nursing practice, nursing policy and procedure manuals, and
written job descriptions for each level of nursing
personnel;
(c) Coordinating nursing services with
other resident services;
(d) Designating the charge nurses
provided for by this section;
(e) Ensuring that the duties of nursing
personnel shall be clearly defined and assigned to staff
members consistent with the level of education, preparation,
experience, and licensing of each.
C. CHARGE NURSES IN SKILLED CARE
FACILITIES AND INTERMEDIATE CARE FACILITIES:
(1) Staffing requirement:
(a) A skilled nursing facility shall
have at least one charge nurse on duty at all times.
(b) An intermediate care facility shall
have a charge nurse during every tour of duty.
(2) Qualifications: Unless otherwise
required under this paragraph, the charge nurses shall be
registered nurses or licensed practical nurses, and shall
have had training, or be acquiring training, or have had
experience in areas such as nursing service administration,
restorative nursing, psychiatric nursing, or geriatric
nursing.
(3) Duties:
(a) The charge nurse, if a registered
nurse, shall supervise the nursing care of all assigned
residents, and delegate the duty to provide for the direct
care of specific residents, including administration of
medications by nursing personnel based upon individual
resident needs,, the facility's physical arrangement, and
the staff capability;
(b) The charge nurse, if a licensed
practical nurse, shall manage and direct the nursing and
other activities of other licensed practical nurse and less
skilled assistants and shall arrange for the provision of
direct care to specific residents, including administration
of medications, by nursing personnel based upon individual
resident needs, the facility's physical arrangement, and the
staff capability.
[7-1-60, 5-2-89; 7.9.2.50 NMAC – Rn, 7
NMAC 9.2.50, 8-31-00]
7.9.2.51 NURSING STAFF: In addition to
the requirements of Section 7.9.2.50 NMAC, the following
conditions shall be met:
A. ASSIGNMENTS: There shall be
sufficient nursing service personnel assigned to care for
the specific needs of each resident on each tour of duty.
Those personnel shall be briefed on the condition and
appropriate care of each resident prior to beginning
hands-on care of residents.
B. RELIEF PERSONNEL: Facilities shall
obtain qualified relief personnel.
C. RECORDS, WEEKLY SCHEDULES: Weekly
time schedules shall be planned at least one week in
advance, shall be posted and dated, shall indicate the names
and classifications of nursing personnel and relief
personnel assigned on each nursing unit for each tour of
duty, and shall be updated as changes occur.
D. STAFF MEETINGS: Meetings shall be
held at least quarterly for the nursing personnel to brief
them on new developments, raise issues relevant to the
service, and for such other purposes as are pertinent.
E. TWENTY-FOUR (24) HOUR COVERAGE: All
facilities shall have at least one nursing staff person on
duty at all times.
F. STAFFING PATTERNS: The assignment of
the nursing personnel required by this subsection to each
tour of duty shall be sufficient to meet each resident’s
needs and implement each resident’s comprehensive care plan.
(1) Nursing department personnel means,
the director of nursing, the assistant director of nursing,
nursing department directors, licensed nursing personnel,
certified nursing assistants, nursing assistants who have
completed 16 hours or more of orientation and demonstrated
competency and restorative nursing assistants.
(2) The director of nursing, the
assistant director of nursing, and nursing department
directors may be counted towards the minimum staffing
requirements only for the time spent on the shift providing
direct resident care services.
(a) A skilled nursing facility or
facility that offers intermediate and skilled nursing shall
maintain a nursing department minimum staffing level of two
and a half (2.5) hours per patient day calculated on a seven
(7) day average.
(b) An intermediate care facility shall
maintain a nursing department minimum staffing level of two
and three-tenths (2.3) hours per patient day calculated on a
seven (7) day average.
(c) Within one hour of shift change,
facilities shall post the number of nursing personnel on
duty in a conspicuous and consistent location for public
review. Shifts are informally defined as the day shift,
evening shift, and night shift. Employees working variations
of these shifts shall be included within the
shift count where a majority of the hours fall.
EXAMPLE: For a
facility with 100 patients, 2.3 hours per patient day averages
one nursing department employee on duty for approximately every
10 to 11 patients. For a facility with 100 patients, 2.5 hours
per patient day averages one nursing department employee for
every 9 to 10 patients. These are daily averages that will vary
from shift to shift so that actual staffing might approximate:
2.3 Hours Per Patient Day
2.5 Hours Per Patient Day
Day
Shift 1 staff for 8 patients 1
staff for 7 patients
Evening
Shift 1 staff for 10 patients 1 staff
for 10 patients
Night
Shift 1 staff for 13 patients 1 staff
for 12 patients
[7-1-60, 5-2-89; 7.9.2.51 NMAC – Rn & A, 7
NMAC 9.2.51, 8-31-00] |
