Title 23
Health and Safety

Chapter 17.5
Rights of Nursing Home Patients

§ 23-17.5-34. Nursing staff posting requirements.

(a) Each nursing facility shall post its daily direct care nurse staff levels by shift in a public place within the nursing facility that is readily accessible to and visible by residents, employees, and visitors. The posting shall be accurate to the actual number of direct care nursing staff on duty for each shift per day. The posting shall be in a format prescribed by the director, to include:

(1) The number of registered nurses, licensed practical nurses, certified nursing assistants, medication technicians, licensed physical therapists, licensed occupational therapists, licensed speech-language pathologists, mental health workers who are also certified nurse assistants, and physical therapist assistants;

(2) The number of temporary, outside agency nursing staff;

(3) The resident census as of twelve o’clock (12:00) a.m.; and

(4) Documentation of the use of unpaid eating assistants (if utilized by the nursing facility on that date).

(b) The posting information shall be maintained on file by the nursing facility for no less than three (3) years and shall be made available to the public upon request.

(c) Each nursing facility shall report the information compiled pursuant to section (a) of this section and in accordance with department of health regulations to the department of health on a quarterly basis in an electronic format prescribed by the director. The director shall make this information available to the public on a quarterly basis on the department of health website, accompanied by a written explanation to assist members of the public in interpreting the information reported pursuant to this section.

(d) In addition to the daily direct nurse staffing level reports, each nursing facility shall post the following information in a legible format and in a conspicuous place readily accessible to and visible by residents, employees, and visitors of the nursing facility:

(1) The minimum number of nursing facility direct care staff per shift that is required to comply with the minimum staffing level requirements in § 23-17.5-32; and

(2) The telephone number or internet website that a resident, employee, or visitor of the nursing facility may use to report a suspected violation by the nursing facility of a regulatory requirement concerning staffing levels and direct patient care.

(e) No nursing facility shall discharge or in any manner discriminate or retaliate against any resident of any nursing facility, or any relative, guardian, conservator, or sponsoring agency thereof or against any employee of any nursing facility or against any other person because the resident, relative, guardian, conservator, sponsoring agency, employee, or other person has filed any complaint or instituted or caused to be instituted any proceeding under this chapter, or has testified or is about to testify in any such proceeding or because of the exercise by the resident, relative, guardian, conservator, sponsoring agency, employee, or other person on behalf of himself, herself, or others of any right afforded by §§ 23-17.5-32, 23-17.5-33, and 23-17.5-34. Notwithstanding any other provision of law to the contrary, any nursing facility that violates any provision of this section shall:

(1) Be liable to the injured party for treble damages; and

(2)(i) Reinstate the employee, if the employee was terminated from employment in violation of any provision of this section; or

(ii) Restore the resident to the resident’s living situation prior to such discrimination or retaliation, including the resident’s housing arrangement or other living conditions within the nursing facility, as appropriate, if the resident’s living situation was changed in violation of any provision of this section. For purposes of this section, “discriminate or retaliate” includes, but is not limited to, the discharge, demotion, suspension, or any other detrimental change in terms or conditions of employment or residency, or the threat of any such action.

(f)(1) The nursing facility shall prepare an annual report showing the average daily direct care nurse staffing level for the nursing facility by shift and by category of nurse to include:

(i) Registered nurses;

(ii) Licensed practical nurses;

(iii) Certified nursing assistants;

(iv) Medication technicians;

(v) Licensed physical therapists;

(vi) Licensed occupational therapists;

(vii) Licensed speech-language pathologists;

(viii) Mental health workers who are also certified nurse assistants;

(ix) Physical therapist assistants;

(x) The use of registered and licensed practical nurses and certified nursing assistant staff from temporary placement agencies; and

(xi) The nurse and certified nurse assistant turnover rates.

(2) The annual report shall be submitted with the nursing facility’s renewal application and provide data for the previous twelve (12) months and ending on or after September 30, for the year preceding the license renewal year. Annual reports shall be submitted in a format prescribed by the director.

(g) The information on nurse staffing shall be reviewed as part of the nursing facility’s annual licensing survey and shall be available to the public, both in printed form and on the department’s website, by nursing facility.

(h) The director of nurses may act as a charge nurse only when the nursing facility is licensed for thirty (30) beds or less.

(i) Whenever the licensing agency determines, in the course of inspecting a nursing facility, that additional staffing is necessary on any residential area to provide adequate nursing care and treatment or to ensure the safety of residents, the licensing agency may require the nursing facility to provide such additional staffing and any or all of the following actions shall be taken to enforce compliance with the determination of the licensing agency:

(1) The nursing facility shall be cited for a deficiency and shall be required to augment its staff within ten (10) days in accordance with the determination of the licensing agency;

(2) If failure to augment staffing is cited, the nursing facility shall be required to curtail admission to the nursing facility;

(3) If a continued failure to augment staffing is cited, the nursing facility shall be subjected to an immediate compliance order to increase the staffing, in accordance with § 23-1-21; or

(4) The sequence and inclusion or non-inclusion of the specific sanctions may be modified in accordance with the severity of the deficiency in terms of its impact on the quality of resident care.

(j) No nursing staff of any nursing facility shall be regularly scheduled for double shifts.

(k) A nursing facility that fails to comply with the provisions of this chapter, or any rules or regulations adopted pursuant thereto, shall be subject to a penalty as determined by the department.