Section 325.21704. Specialized nursing services.

Rule 1704. Specialized nursing services in a developmental disability nursing home or nursing facility shall comply with all of the following provisions:

(a)   Be directed by a registered nurse who has at least 1 year of work experience in the care of developmentally disabled patients or who, in the opinion of the physician specialist on the staff of the facility, is qualified to supervise the nursing care and habilitative and developmental training services for developmentally disabled patients.

(b)   Provide that nursing care for patients on all shifts in the facility shall be in the charge of a registered nurse or licensed practical nurse experienced in the care of developmentally disabled patients.

(c)     Provide that the nursing staff shall receive orientation in the provision of habilitative and developmental training services necessary to the care of developmentally disabled patients. Nursing personnel shall receive specialized inservice training on a regular and continuing basis.

(d)   Provide, in addition to personnel required for compliance with nurse staffing requirements for licensure and skilled nursing facility certification, additional licensed and unlicensed personnel required to meet the needs of individual patients, but not less than 4.35 hours of nursing care per patient per 24 hours of residence. In addition, the following provisions shall be complied with:

(i)   The ratio of patients present to nursing care personnel from the hours of 6 a.m. to 8 p.m. shall not exceed 4 patients to 1 nursing care personnel.

(ii)   For the hours of 8 p.m. to 6 a.m., the ratio of patients to nursing care personnel shall not exceed 12 patients to 1 nursing care personnel.

(iii)    In addition to the provisions of paragraphs (i) and (ii) of this subdivision, there shall be sufficient nursing care personnel available on duty to assure coverage for patients at all times during each shift.

History: 1981 AACS; 2014 AACS.