All of us in the “industry” understand the difficulty we face with appropriately staffing 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! The state of West Virginia mandates the following regulation as to the staffing ratio and requirements of said staff for all assisted living facilities:
4.4. Staffing Requirements.
4.4.1. Each assisted living residence shall have a minimum of one direct care staff person 24 hours per day, who can read and write, and shall have a sufficient number of qualified employees on duty to provide the residents with all of the care and services they require. (Class I)
4.4.1.a. Day shift – In addition to the one direct care staff person on the day shift, the residence shall have one direct care staff on the day shift for each 10 residents identified on their needs assessments to have two or more of the following care needs: dependence on staff for eating, toileting, ambulating residents from one location to another, bathing, dressing, repositioning, oral hygiene, personal grooming, or one or more inappropriate behaviors that reasonably require additional staff to control, such as sexually acting out, stripping in public settings, refusing basic care, destroying property, or injurious behavior to self or others (hereinafter referred to as “special care needs”);
4.4.1.b. Evening shift – In addition to the one direct care person on the evening shift, the residence shall have at least one additional direct care staff on the evening shift for each 15 residents identified on their functional needs assessments to have two or more special care needs;
4.4.1.c. Night shift – In addition to the one direct care person on the night shift, the residence shall have at least one additional direct care staff on the night shift for each 18 residents identified on their functional needs assessments to have two or more special care needs.
4.4.2. One employee who has current first aid training and current cardiopulmonary resuscitation (CPR) training, as applicable, shall be on duty at all times. A record of this training shall be available for review. (Class I)
4.4.3. A multi-story residence shall have at least one awake staff per story while residents are sleeping, unless the residents are certified by a physician or psychologist as not in need of sleep time supervision, and the residence has an emergency call system from the residents to the awake staff person. (Class I)
4.4.4. The residence shall have sufficient staff to meet the laundry, food service, housekeeping, and maintenance requirements of this rule. (Class II)
4.4.5. The licensee shall maintain staffing records that accurately reflect the actual employees on duty in the residence at any given time, including the hours they have worked and the positions they worked, and provide them to the Secretary upon request. (Class III)
4.4.6. If a resident experiences a poor outcome related to a lack of supervision or unmet care needs, the Secretary may require the licensee to add staff. (Class I)
- 4, 4.4.1a, 4.4.1b, 4.4.1c Staffing Ratio
Due to the stipulation in this subsect your staffing ratios essentially boil down to; Day- 1:10+1, Evening- 1:15+1, Night- 1:18+1. The +1 is the staff member required in section 4.4.1. While OHFLAC provides facilities with a required ratio it should be noted that you must staff for the needs of your facility, as the number is a MINIMUM requirement. If you have multiple residents who require more assistance you will need to have more staff to ensure the services are provided.