Nursing Services Requirements for the State of North Carolina
10A NCAC 13D .2302 NURSING SERVICES
(a) The facility shall designate a
registered nurse to serve as the director of nursing on a
full‑time basis.
(b) The director of nursing shall be
responsible for the administering of nursing services.
(c) The director of nursing may serve
also as nurse-in-charge, only if the average daily occupancy
is less than 60.
(d) The director of nursing shall not
serve as administrator, assistant administrator or acting
administrator during an employment vacancy in the
administrator position.
History Note: Authority G.S.
131E‑104;
RRC objection due to lack of statutory
authority Eff. July 13, 1995;
Eff. January 1, 1996.
10A NCAC 13D .2303 NURSE STAFFING
REQUIREMENTS
(a) The facility shall provide
licensed nursing personnel consistent with applicable
occupational regulations and sufficient to accomplish the
following:
(1) patient needs assessment;
(2) patient care planning; and
(3) supervisory functions in accordance
with the levels of patient care advertised or offered by the
facility.
(b) The facility shall provide other
nursing personnel sufficient to ensure that activities of
daily living, personal care, delegated restorative nursing
tasks and other health care needs, as identified in each
patient's plan of care, are met.
(c) A multi‑storied facility shall
have at least one direct‑care staff member on duty on each
patient care floor at all times.
(d) Except for designated units with
higher staffing requirements noted elsewhere in this
Subchapter, daily direct patient care nursing staff,
licensed and unlicensed, shall equal or exceed 2.1 nursing
hours per patient per day. (This is sometimes referred to
as nursing hours per patient day or NHPPD or NH/PD.)
(1) Inclusive in these nursing hours
is the requirement that at least one licensed nurse is on
duty for direct patient care at all times.
(2) Nursing care shall include the
services of a registered nurse for at least eight
consecutive hours a day, seven days a week. This coverage
can be spread over more than one shift if such a need
exists. The director of nursing may be counted as meeting
the requirements for both the director of nursing and
patient staffing for facilities with a total census of 60
nursing beds or less.
(3) Nursing support personnel,
including ward clerks, secretaries, nurse educators and
persons in primarily administrative management positions and
not actively involved in
direct patient care, shall not be counted
toward compliance with minimum daily requirements for direct
care staffing. (e) An exception to meeting the minimum
staffing requirements shall be reported to the Department at the
end of each month. Staffing waivers granted by the federal
government for Medicare and Medicaid certified beds shall be
accepted for licensure purposes.
History Note: Authority G.S. 131E‑104;
Eff. January 1, 1996. |
