All of us in the “industry” understand the difficulty we face with staffing appropriately in our facilities. These positions are tough and consuming for people (especially during the time of writing this article; see COVID-19) and can leave many burnt out. But it is also an incredibly rewarding experience for employees to share their compassion for others and provide care to seniors! These employees in an ARCP must be held to high standards and are regulated by the DHH under the following statute:
- 6865. Staffing Requirements
- At a minimum, the following staff positions are required. For ARCPs level 2 through 4, one person may occupy more than one position in the ARCP but shall not be in this position on the same shift. In a level 1 ARCP, one person may occupy more than one staff position on the same shift.
- Director. Each ARCP shall have a qualified director who is responsible for the day-to-day management, supervision, and operation of the ARCP and who shall be on-site no less than 20 hours per week.
- During periods of temporary absence of the director, there shall be a responsible staff person designated to be in charge 24 hours per day, seven days per week that has the knowledge and responsibility to handle any situation that may occur.
- The director shall be at least 21 years of age and have the responsibility and authority to carry out the policies of the provider.
- Director Qualifications
- For levels 1 and 2, the director shall meet one of the following criteria upon the date of hire:
(a). have at least an associate’s degree from an accredited college plus one year of experience in the fields of health, social services, geriatrics, management or administration; or
(b). in lieu of an associate’s degree from an accredited college three years of experience in health, social services, geriatrics, management, administration; or
(c). a bachelor’s degree in geriatrics, social services, nursing, health care administration, or related field.
- For levels 3 and 4, the director shall meet one of the following criteria upon the date of hire:
(a). a bachelor’s degree plus two years of administrative experience in the fields of health, social services, geriatrics, management, or administration;
(b). in lieu of a bachelor’s degree, six years of administrative experience in health, social services, geriatrics, management, or administration;
(c). a master’s degree in geriatrics, health care, human service related field, management or administration; or
(d). be a licensed nursing facility administrator. iii. Additionally, for level 4 ARCPs the director shall have successfully completed an adult residential care/assisted living director certification/training program consisting of, at a minimum, 12 hours of training that has been approved by any one of the following organizations: (a). Louisiana Board of Examiners of Nursing Facility Administrators; (b). Louisiana Assisted Living Association (LALA); (c). LeadingAge Gulf States; (d). Louisiana Nursing Home Association (LNHA); or (e). any of the national assisted living associations, including the:
(i). National Center for Assisted Living (NCAL);
(ii). Assisted Living Federation of America (ALFA); or
- Training shall begin within six months and completed within 12 months of being appointed director.
- Two years of experience as an assisted living director may be substituted in lieu of the certification requirements. vi. Documentation of the director’s qualifications shall be maintained on file at the ARCP.
- Designated Recreational/Activity Staff (Staffing Requirements). There shall be an individual designated to organize and oversee the recreational and social programs of the ARCP.
- Direct Care Staff
- The ARCP shall demonstrate that sufficient and trained direct care staff is scheduled and on-site to meet the 24-hour scheduled and unscheduled needs of the residents.
- The ARCP shall be staffed with direct care staff to properly safeguard the health, safety, and welfare of clients.
- The ARCP shall employ direct care staff to ensure the provision of ARCP services as required by the PCSP.
- Staff shall not work simultaneously at more than one ARCP on the same shift.
- A direct care staff person who is not in the ARCP, but who is scheduled on the shift as on-call shall not be included as direct care staff on any shift.
- The ARCP shall maintain a current work schedule for all employees indicating adequate coverage for each 24-hour day.
- Nursing Staff ( Staffing Requirements)
- In ARCPs that offer staff medication administration and level 4 ARCPs, the ARCP shall provide a sufficient number of RNs and LPNs to provide services to all residents in accordance with each resident’s PCSP 24 hours per day.
- Nursing Director
- Level 4 ARCPs shall employ or contract with at least one RN who shall serve as the nursing director and who shall manage the nursing services. The nursing director need not be physically present at all times at the ARCP; however, the nursing director or his or her designee shall be on call and readily accessible to the ARCP 24 hours a day.
- The nursing director, in conjunction with the resident’s physician, shall be responsible for the preparation, coordination, and implementation of the health care services section of the resident’s PCSP.
- The nursing director shall review and oversee all LPNs and direct care personnel with respect to the performance of health-related services.
- The nursing director shall be licensed by, and in good standing with, the Louisiana State Board of Nursing, and shall comply with all applicable licensing requirements.
- Licensed Practical Nurses (LPNs). LPNs employed by or contracted with shall be licensed by, and in good standing with, the Louisiana State Board of Practical Nursing, and shall comply with all applicable nursing requirements.
Although the Staffing Requirements ratio of staff to residents is not specifically stated, it is imperative to understand how the resident’s PCSP is related to the need for appropriate numbers of staff. If you have multiple residents requiring a high level of care you MUST provide more staff due to the increased needs of the facility at all times of the day.