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Agency 28

Department of Health and Environment

Article 39.—Licensure of Adult Care Homes

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28-39-154. Nursing services. Each nursing facility shall have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident as determined by resident assessments and individual plans of care. (a) Sufficient staff. The facility shall employ sufficient numbers of each of the following types of personnel to provide nursing care to all residents in accordance with each resident's comprehensive assessment and care plan.
(1) The nursing facility shall employ full-time a director of nursing who is a registered nurse. The director of nursing shall have administrative authority over and responsibility for the functions and activities of the nursing staff.
(2) A registered nurse shall be on duty at least eight consecutive hours per day, seven days per week. The facility may include the director of nursing to meet this requirement.
(3) A licensed nurse shall be on duty 24 hours per day, seven days per week.
(A) On the day shift there shall be the same number of licensed nurses on duty as there are nursing units.
(B) If a licensed practical nurse is the only licensed nurse on duty, a registered nurse shall be immediately available by telephone.
(4) At least two nursing personnel shall be on duty at all times in the facility. Personnel shall be immediately accessible to each resident to assure prompt response to the resident call system and necessary action in the event of injury, illness, fire, or other emergency.
(5) The nursing facility shall not assign nursing personnel routine housekeeping, laundry, or dietary duties.
(6) Direct care staff shall wear identification badges to identify name and position.
(7) The nursing facility shall ensure that direct care staff are available to provide resident care in accordance with the following minimum requirements.
(A) Per facility, there shall be a weekly average of 2.0 hours of direct care staff time per resident and a daily average of not fewer than 1.85 hours during any 24 hour period. The director of nursing shall not be included in this computation in facilities with more than 60 beds.
(B) The ratio of nursing personnel to residents per nursing unit shall not be fewer than one nursing staff member for each 30 residents or for each fraction of that number of residents.
(C) The licensing agency may require an increase in the number of nursing personnel above minimum levels under certain circumstances. The circumstances may include the following:
(i) location of resident rooms;
(ii) locations of nurses' stations;
(iii) the acuity level of residents; or
(iv) that the health and safety needs of residents are not being met.
(b) The nursing facility shall maintain staffing schedules on file in the facility for 12 months and shall include hours actually worked and the classification of nursing personnel who worked in each nursing unit on each shift. (Authorized by and implementing K.S.A. 39-932; effective Nov. 1, 1993; amended Feb. 21, 1997.)
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