HAR §17-1737-118. Staffing standards

(a) For the purpose of this section, each licensed nursing staff shall be counted as one. Each subacute unit shall be under the supervision of a registered nurse twenty-four hours a day. (b) Subacute units authorized to provide care to respirator or ventilator dependent patients shall provide a minimum daily average of 9.0 nursing care hours of which 5.0 hours shall be provided by the nursing staff. Where there is a mix of ventilator- dependent and other patients, the facility shall provide no less than 5.0 licensed and certified hours per patient per day. Subacute units without UNOFFICIAL 1737-116 ventilator patients shall employ sufficient licensed staff to provide a minimum daily average of 5.0 licensed and certified nursing hours. (c) The department may require a facility to provide additional staff in accordance with subsection (b). (d) Registered nurses and licensed practical nurses shall have a minimum of six months experience (within the past two years) in a direct participatory general acute care facility where the caseload included patients requiring intensive care and the use of special equipment. Completion of a department of human services approved subacute training course may be substituted for this requirement. (e) The experience stated in subsection (d) or substitute clinical training for licensed nurses shall include respirator and tracheostomy care, nasogastric tube and gastrostomy care, administration of total parenteral nutrition and traction care. In addition, this requirement shall be completed prior to treating subacute patients. Registered nurses shall be certified by the facility to perform intravenous procedures and cardiopulmonary resuscitation. (f) The facility shall provide documentation that all staff participating in direct patient care, including the director of nursing, registered nurses, licensed practical nurses, and nurse's aide staff have continuing in-service training pertinent to the subacute level of care and shall make documentation available upon request by the department of human services at the time of the facility inspection. [Eff 11/25/96 ] (Auth: HRS §346-14; 42 C.F.R. §431.10) (Imp: HRS §346-14)