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https://www.health.pa.gov/topics/disease/coronavirus/Pages/Guidance/Staffing-Resources.aspx#:~:text=The%20total%20number%20of%20hours%20of%20general%20nursing,hours%20of%20direct%20resident%20care%20for%20each%20resident.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328494/
A CMS study in 2001 established the importance of having a minimum of 0.75 RN hours per resident day (hprd), 0.55 licensed nurse (LVN/LPN) hprd, and 2.8 (to 3.0) CNA hprd, for a total of 4.1 nursing hprd to prevent harm or jeopardy to residents. 1 As part of this study, a simulation model of direct care workers (CNAs) established the minimum number of staff necessary to provide 5 basic aspects …
https://www.cdph.ca.gov/Programs/OLS/CDPH%20Document%20Library/DPH-17-011E-FOE.pdf
regulations to implement new minimum staffing requirements for SNFs as established by SB 97. Enacted in July 2017, SB 97 increased the minimum staffing standard for SNFs from 3.2 nursing hours per patient day (NHPPD) to 3.5 direct care service hours per patient day (DCSHPPD), with a minimum of 2.4 hours per patient day performed by
https://www.dol.gov/agencies/whd/fact-sheets/31-flsa-nursing-care
Under the "8 and 80" system, the nursing care facility may pay employees -- with whom they have a prior agreement -- overtime for any hours worked after more than 8 hours in a day and more than 80 hours in a 14-day period. Recordkeeping: Employers are required to maintain accurate payroll and time records. Time records must be preserved for two years and payroll records must be kept for three years.
https://medicareadvocacy.org/mandatory-nurse-staffing-levels/
In 2000, California amended its law both to raise the minimum nursing staff requirement from 3.0 to 3.2 hours of direct resident care per day and to eliminate the prior policy of allowing RN or LPN hours to be counted double toward meeting the staffing standard. In 2002, Ohio increased its minimum total direct care hours from 1.6 to 2.75.
https://www.justice.gov/sites/default/files/nursing_home_staffing_standards_in_state_statutes_and_regulations.pdf
sufficient nursing staff to provide a minimum daily average of 3.2 nursing hours per patient day. LICENSED STAFF (RN, LPN/LVN) For 1-59 licensed beds: 1 RN/LVN 24 hours/day For 60-99 licensed beds: 1 DON RN Day Full Time (may not be charge nurse) and 1 RN/LVN 24 hours/day For 100+ beds: 1 DON RN (may not be charge nurse) and 1 RN 24 hours/day
https://www.ilga.gov/commission/jcar/admincode/077/077003000F12300R.html
d) The minimum staffing ratios shall be 3.8 hours of nursing and personal care each day for a resident needing skilled care and 2.5 hours of nursing and personal care each day for a resident needing intermediate care. (Section 3-202.05(d) of the Act) For the purpose of this subsection, "nursing care" and "personal care" mean direct care provided by staff listed in subsection (i).
https://www.health.pa.gov/topics/disease/coronavirus/Pages/Guidance/Staffing-Resources.aspx
The total number of hours of general nursing care provided in each 24-hour period must, when totaled for the entire facility, be a minimum of 2.7 hours of direct resident care for each resident. The Department understands that during the COVID-19 pandemic nursing care facilities may not be able to maintain the 2.7 Per Patient Day (PPD) requirement.
https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-12-44
However, it is important to note that the average direct nursing care hours (from Table 1) were 4.95 per patient day, only approximately 21% of a full patient care day (24 h). That is apparently inadequate based on the evidence of positively correlation between the direct nursing care hours and patient mortality.
http://www.canhr.org/factsheets/nh_fs/html/fs_CareStandards.html
Nursing homes must have sufficient nursing and other employees to meet the needs of each resident in the nursing home at all times. 9 Additionally, California requires skilled nursing facilities to provide a minimum of 3.2 hours of nursing care per resident per day. 10 If this staffing level is not adequate to meet resident needs, the nursing home must employ as many licensed nursing and …
https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000319.asp
Nursing facilities that receive Medicaid and Medicare payments must provide sufficient licensed nursing services 24 hours a day, including a registered nurse for at least 8 consecutive hours every day.
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