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Nursing Staffing Requirements to Meet the Demands of Today’s Long Term Care Consumer

Recommendations from the Coalition of Geriatric Nursing Organizations (CGNO)

CGNO Position Statement Endorsed by ANA: November 12, 2014

The CGNO proposes that the following minimum staffing levels be adopted, funded, implemented, and publicly reported for nursing homes:

  • A registered nurse be present in the nursing home at all times for oversight of resident care, resident assessment, supervision of licensed nursing staff and delegation to certified nursing assistants.
  • The Director of Nursing be either prepared at the baccalaureate level or certified in nursing administration by one of the CGNO associations. 
  • The hours of direct nursing care for each resident be at least 4.1 hours per resident day with minimum 30% of that consisting of licensed nurses.
  • Administrative RN positions such as the Director of Nursing and Assistant Director of Nursing not be counted as direct nursing hours for resident care.
  • Skilled nursing facility residents have licensed staffing based on clinical acuity, which may necessitate more than the 4.1 hours per resident minimum.

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