Nursing homes and other healthcare facilities must ensure that they have a registered nurse (RN) providing services for at least 8 consecutive hours a day, 7 days a week. The facility must also designate a registered nurse to serve as the Director of Nursing on a full-time basis, and the Director of Nursing may serve as a charge nurse only when the facility has an average daily occupancy of 60 or fewer residents. The facility is responsible for submitting staffing data through the PBJ and must ensure that an RN is onsite for 8 hours a day in order to meet the needs of residents with high acuity. If concerns are identified, the facility must refer to the Critical Element pathway Sufficient and Competent Staffing for further investigation. Facilities must also ensure that the Director of Nursing does not serve as a charge nurse when the facility has an average daily occupancy of more than 60 residents. If not, they may be subject to a Severity Level 3 or 4 Noncompliance.

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