5.1 The administrator(s) shall be responsible for complying with all applicable laws and regulations.

5.2 Each nursing facility shall have a full-time administrator. When an administrator will be temporarily absent for a
period of two weeks or more, a management employee shall be designated to be in charge. The Division shall
be notified in writing upon such designation.

5.3 The nursing facility shall designate a physician to serve as the medical director who shall be responsible for
implementation of resident care policies and the coordination of medical care in the facility.

5.4 Nursing facilities shall provide professional nursing, nursing services direct care and other services as follows:
5.4.1 Nursing facilities subject to 16 Delaware Code, §1161 to §1165 shall provide professional nursing, nursing
services direct care and other services in accordance with statutory requirements.
5.4.2 Nursing facilities not subject to 16 Delaware Code, §1161 to §1165 shall provide
professional nursing, nursing services direct care and other services as follows:
5.4.2.1 The facility shall provide a sufficient number of nursing services direct care staff to provide a
minimum of 2.25 hours of direct care and treatment per resident per day.
5.4.2.2 In addition to the requirement above, the nursing facility shall have a full-time
director of nursing who is a registered nurse. The director of nursing shall have overall
responsibility for the coordination, supervision and provision of nursing services.
5.4.2.3 At a minimum, a registered nurse or licensed practical nurse shall be on duty at all times during the
first and second shifts.
5.4.2.4 At a minimum, in the absence of a nurse on the third shift, a registered nurse or licensed practical
nurse shall be on call.
5.4.2.5 Facilities not subject to 16 Delaware Code, §1164 may increase the level of care and services for
a current resident whose condition requires such an increase in the level of care and services as
an alternative to discharge to another facility. Such increased care and services shall be provided
by a qualified caregiver(s) whose scope of practice includes the provision of such care and
services, and shall be available during any shift when the resident’s needs require such care and
services.
5.4.2.6 All other nursing services direct caregivers shall be certified nursing assistants.
5.4.2.7 The facility shall employ an activities director who shall ensure the provision of activities as
described in these regulations.

5.5 The facility shall have written personnel policies and procedures. Personnel records shall be kept current and
available for each employee, and include the following:
5.5.1 Results of tuberculosis screening
5.5.2 Documentation of annual influenza vaccination or refusal.
5.5.3 Results of criminal background check
5.5.4 Results of mandatory drug testing
5.5.5 Result of Adult Abuse Registry check
5.5.6 Titles and hours of in-service training
5.5.7 If applicable, license number and expiration date
5.5.8 If applicable, certification expiration date
5.6 Dementia Training

5.6.1 Nursing facilities that provide direct healthcare services to persons diagnosed as having Alzheimer’s
disease or other forms of dementia shall provide dementia specific training each year to those healthcare
providers who must participate in continuing education programs. This section shall not apply to persons
certified to practice medicine under the Medical Practice Act, Chapter 17 of Title 24 of the Delaware Code.

5.6.2 The mandatory training must include: communicating with persons diagnosed as having Alzheimer’s
disease or other forms of dementia; the psychological, social, and physical needs of those persons; and
safety measures which need to be taken with those persons.

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