What are the Staff Requirements in Nursing Homes?

Nursing homes are responsible for the 24-hour care of patients who cannot care for themselves, whether bed bound, handicapped or with other physical or mental conditions that make constant care a necessity. While nursing homes vary in quality and the degree of care provided, some federally mandated staffing requirements apply to all nursing homes. States can pass local laws that exceed the federal minimums, but all nursing home must have at least the federal minimum staff in place.

Registered Nurses

• Federal law requires a registered nurse (RN) to be on duty in a nursing home for at least eight consecutive hours each day of the week, including weekends. According to the Kaiser Family Foundation website, the law allows the Director of Nursing at a nursing home to act as the registered nurse on duty in some instances.

  For the Director of Nursing to count as the registered nurse on duty for that shift, the nursing home must have no more than 60 residents, and the Director of Nursing must be available to provide direct care to the residents in addition to any administrative duties.

Licensed Nurses

• At least one licensed nurse should be on duty at all times in a nursing home, according to the Kaiser Family Foundation website. The registered nurse can fill the legal requirement, but many nursing homes choose to staff another nurse in addition to the registered nurse.

  The law ensures the immediate availability of a nurse 24 hours per day. The nurse on duty may be a registered nurse or a vocational (LVN) or practical nurse (LPN).

Assistants, Aides and Other Staff

• No federal laws govern the number of specific additional staff members required for a nursing home. However, the federal regulations do mandate that "each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance

  with the comprehensive assessment and plan of care."

Hours Per Resident Day (HPRD)

• When staffing a nursing home, determine a sufficient staff roster by calculating the hours per resident day (HPRD). The HPRD is figured by dividing the number of scheduled hours by the number of residents being cared for. For example, the federal HPRD recommendation for licensed nurses on duty is 0.30 HPRD. This number comes from an example of 30 scheduled nurse-hours in one day to care for 100 resident patients. Thirty divided by 100 equals 0.30.