Effective Staffing Ratio

All of us in the “industry” understand the difficulty we face with appropriately staffing our facilities. These care 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! The state of Pennsylvania mandates the following regulation as to the staffing ratio and requirements of said staffs for all assisted living facilities:

  • 2800.57. Direct care staffing.

(a) At all times one or more residents are present in the residence, a direct care staff person who is 21 years of age or older shall be present in the residence. The direct care staff person may be the administrator if the administrator provides direct care services.

(b) Direct care staff persons shall be available to provide at least 1 hour per day of assisted living services to each mobile resident.

(c) Direct care staff persons shall be available to provide at least 2 hours per day of assisted living services to each resident who has mobility needs.

(d) At least 75% of the assisted living service hours specified in subsections (b) and (c) shall be available during waking hours. This section cited in 55 Pa. Code § 2800.59 (relating to multiple buildings); and 55 Pa. Code § 2800.238 (relating to staffing).

  • 2800.58. Awake staff persons.

Direct care staff persons on duty in the residence shall be awake at all times

  • 2800.60. Additional staffing based on the needs of the residents.

(a) Staffing shall be provided to meet the needs of the residents as specified in the resident’s assessment and support plan. Residence staff or service providers who provide services to the residents in the residence shall meet the applicable professional licensure requirements.

(b) The staffing level in this chapter is minimum only. The Department may require additional staffing as necessary to protect the health, safety and wellbeing of the residents. Requirements for additional staffing will be based on the resident’s assessment and support plan, the design and construction of the residence and the operation and management of the residence.

(c) Additional staff hours, or contractual hours, shall be provided as necessary to meet the transportation, laundry, food service, housekeeping and maintenance needs of the residents.

(d) In addition to the staffing requirements in this chapter, the residence shall have a licensed nurse available in the building or on call at all times. The licensed nurse shall be either an employee of the residence or under contract with the residence.

(e) The residence shall have a dietician on staff or under contract to provide for any special dietary needs of a resident as indicated in his support plan

Top Takeaway:

  • (a) Staffing shall be provided to meet the needs of the residents as specified in the resident’s assessment and support plan. Residence staff or service providers who provide services to the residents in the residence shall meet the applicable professional licensure requirements.

The staffing ratio in your facility is directly related to the services that are needed by your residents. There is no magic number of staff you need to have on shift at any given time. Your team must be able to meet the hourly needs of all residents while abiding by the state regulation.