Nursing Services Flashcards
There must be at least ONE RN employed by the facility for?
-Both-(483.30/19.1001-1)
8 consecutive hours a day 7 days a week
How many LN’s must a facility have?
-Both-(483.30/19.1001-1)
One nurse for each shift 7 days a week
-State-
Ratio is 1:20
Who is required to serve as a charge nurse?
-Both-(483.30/19.1001-1)
LN’s or higher for each shift (3) 7 days a week.
when can the DON serve as a charge nurse?
-Both-(483.30/19.1001-1)
When the facility has an average daily occupancy of 60 or fewer residents.
How many hours is the DON expected to work?
-Both-(483.30/19.1001-2)
40 hours a week
Who can serve as the DON?
-Both-(483.30/19.1001-2)
a RN
How often is the wavier to 24 hour nursing care subject to review?
-Both-(483.30/19.1001-1)
Once a year
What is the WAVIER requirement to NOT have a LN coverage on shift for 24 hours?
-Both-(483.30/19.1001-3)
1- Unable to Hire, at appropriate rates
2-DADS determines , based on population, that health and safety will not endanger
3-Must have a RN or LN on the day shift 7 days a week (6-9) day shift
When WAVIER for 24 hour nurse coverage is given who must cover the facility in case of emergency (phone call)
-Both-(483.30/19.1001-3-a-3)
a registered nurse or a physician is obligated to respond immediately to telephone calls from the facility
Can the requirement to have a 8 hours a day 7 days a week RN coverage week be waived in a Medicare? (Including DON)
-Both-(483.30/19.1001-4)
Yes,
1- provided that the SNF is in a RUAL AREA
2-Facility has residents that no not need RN or Doctor assistance for 48 hours
3-When regular full time nurse is off, that arrangements have been made to have a doctor or nurse to be at facility.
If there is a possibility of Nurse staffing issues (staffing will fall for 30 of 45 days) what must the Administrator do?
-State Only-19.1001-5 1-Notify DADS regulatory Services Division 2-Notice must be in writing 3-Notify Residents 4-Notify Family
What are the two type of waivers that have to do with NURSE STAFFING?
-Both-
1- 24 Hour coverage of Licensed Nurse
2-8 hours a day 7 Day a Week RN
How long must a facility keep record of all Nurse Staff posting requirements?
19.1001-b-4 1-Facility Policy OR; 2- AT least Two years ** what ever is longer ***Fed Requirement is 18 months (483.30-e-2-4)
What is the minimum ratio for Licensed Nurse Staff?
-State Only-19.1002
1:20 – 1 Nurse for every 20 residents (per shift)
Ex: 3 Shifts for 1 Nurse = 3*20 = 60 Residents OR
Minimum of .4 Hours per Resident Day.
Ex: 3 Nurses working 8 hour shifts = 24 Hours
Divide that by 60 Residents = .4
** Note LN can be counted in ratio, but only if that work is nurse related, and not admin duties. (ANN at modern in charge of medical supplies)
What nursing staff information must be posted on the beginning of each shift?
-Both-(483.30/19.1001-b)
1-Total number of hours to be worked,
2-What shift (time of day)
Can the DON be the DON in two different facilities?
-State-19.1004
No,
The director of nursing services must serve only one facility in this capacity.
If a phone verbal ORDER (phone) is give to a LN who must sign the ORDER?
-State-19.1010-d-
1-The nurse who took the order &
2-The Doctor (ect..) who gave the order in a TIMELY manner
How often must a NURSE (Enter/Approve/Sign) Nurses NOTES?
-State-19.1010-e-
Once a Month OR
When physical complaints, accidents, incidents, and change in condition or diagnosis happen. - These must happen promptly-
When are deaths reported to DHS? (Texas Department of Human Services)
-State-19.1010-f-
Monthly [as part of a routine process.]
(10 days after the first of the month.) 19.606
When must death be reported immediately?
-State-19.1010-f-
When the death involves TRAMA, or something unusual.
Can nurse students be counted in the NURSE to Resident Ratio?
-State-19.1011
No
Who is responsible for PAYMENT of a Nurse sitter in a Medicaid facility?
-State-19.1012
The Family, or Resident - NOT the FACILITY
What is the OLDER AMERICANS ACT of 1965 best known for?
-Both- (483.30/19.1001)
Providing a Long Term Care OMBUDSMAN
When can a graduate LN work in a facility, when they only have a temp work permit?
-State-19.1002-b-
Under the direction of:
LN / RN / or Doctor as long as they are:
Physically present in the building/
