State Regulatory Provisions for Residential Care Settings: An Overview of Staffing Requirements

Carder, Paula; O'Keefe, Janet; O’Keefe, Christine L.; White, Erin; Wiener, Joshua M.

doi:10.3768/rtipress.2016.op.0030.1607

Cited by 7 publications

(16 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…State regulatory information for nurse staffing was obtained from a 2014 compendium of RCC regulations and a follow-up report that focused primarily on licensed professional staff (Carder, O’Keeffe, & O’Keeffe, 2015; Carder et al, 2016). Table 1 of the Carder et al (2016) study was used as the framework for categorizing each state by whether the state: (a) had a requirement for a licensed nurse (RN or LPN/LVN) to be on staff or available, either through employment or as a consultant; or (b) did not have a requirement for licensed nurse staffing.…”

Section: Methodsmentioning

confidence: 99%

“…As part of the validation process, the current authors reviewed state-specific regulations from the RCC compendium that focused on staffing. Although the Carder et al (2016) report included other licensed health care professionals such as physicians and physician’s assistants to define licensed staffing, exclusion of this staff type for the purposes of the current analysis did not change the overall categorization of states.…”

Section: Methodsmentioning

confidence: 99%

“…Bureau of Labor Statistics, 2017a,b). Licensed nurse responsibilities in RCCs include coordination and oversight for nursing and medication services (Carder, O’Keeffe, O’Keeffe, White, & Wiener, 2016). In contrast, nurse aides are not licensed, and include a wide range of staff types, including nurse aides who are certified by the state after completing a mandated training course, and personal care aides who lack any certification.…”

mentioning

confidence: 99%

“…RCCs are regulated by states, and state regulations vary, including the mix, scope, and level of nurse staffing required (Carder & O’Keeffe, 2016). Not all states have a requirement for RCC nurse staffing, with some states requiring nurses only if current residents have nursing care needs, and other states requiring full-time nurses (Carder et al, 2016).…”

mentioning

confidence: 99%

See 3 more Smart Citations

Variation in Licensed Nurse Staffing Characteristics by State Requirements in Residential Care

Rome¹,

Harris-Kojetin²,

Carder³

2019

Research in Gerontological Nursing

Self Cite

View full text Add to dashboard Cite

Research on licensed nurses in assisted living and residential care communities (RCCs) is sparse compared to that on licensed nurses in nursing homes. RCCs are state-regulated; thus, staffing requirements vary considerably. The current study analyzed variation in characteristics of licensed nurses by state-specific requirements for licensed nurses in RCCs. A significantly higher percentage of RCCs with one or more RNs (68.87%) and licensed practical nurses (LPNs) or licensed vocational nurses (LVNs) (56.85%) were found among states with licensed nurse requirements compared to states with no such requirements (37.35% and 29.08%, respectively; p < 0.05). LPN/LVN hours were higher among RCCs in states with licensed nurse requirements compared to RCCs in states with no such requirements (17 minutes and 8 minutes, respectively; p < 0.05). The findings provide the first evidence of variation in characteristics of licensed nurses by state-specific requirements for licensed nurses.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Variation in Licensed Nurse Staffing Characteristics by State Requirements in Residential Care

Rome¹,

Harris-Kojetin²,

Carder³

2019

Research in Gerontological Nursing

Self Cite

View full text Add to dashboard Cite

show abstract

“…In AL, fewer than 40% of states specify minimum staffing ratios, and only 25% of states require that direct care staff have at least 11 hours or more of training (compared to a mandated 75 hours in NHs). 26…”

Section: Limited Direct Care Staffing With Minimal Trainingmentioning

confidence: 99%

The Need to Include Assisted Living in Responding to the COVID-19 Pandemic

Zimmerman

Sloane

Katz

et al. 2020

Journal of the American Medical Directors Association

View full text Add to dashboard Cite

The risk of complications and death from COVID-19 is markedly skewed toward older adults. The US Centers for Disease Control and Prevention (CDC) recently wrote, "Given their congregate nature and residents served (eg, older adults often with underlying chronic medical conditions), nursing home populations are at the highest risk of being affected by COVID-19. If infected with SARS-CoV-2, the virus that causes COVID-19, residents are at increased risk of serious illness." 1 However, in the United States and many other countries, nursing homes are not the only congregate setting that serves older adults with underlying chronic medical conditions. More so, they have been a shrinking component of the residential long-term care system, with some of the largest growth having been in assisted living (AL). AL communities provide supportive care, at least 2 meals a day, and 24hour supervision to individuals who need daily supportive care, but not daily nursing care. 2,3 Recent estimates are that there are 30,200 licensed AL communities across the United States, providing care to more than 835,000 residents 4 dwhich constitutes almost 40% of persons who receive residential long-term care in this country. More than half of the AL residents are "old-old" or "oldest-old": 53% are aged 85 or older, compared with 42% in nursing homes and 47% receiving hospice. 4 More so, many have the chronic underlying conditions implicated in COVID-19: 34% have heart disease, 17% have diabetes, and 15% have lung disease (chronic obstructive pulmonary disease and allied conditions), and more than a quarter have between 4 and 10 chronic health conditions. 5 Thus, the AL population is at high risk for being affected by COVID-19 and suffering serious outcomes.Importantly, AL communities are not the same as nursing homes. In fact, there are several distinct components of AL that make this a unique setting and one not to be ignored in relation to planning and response. This editorial summarizes key differences and their related implications for care.

show abstract

COVID-19 Vaccine Uptake Among Residents and Staff Members of Assisted Living and Residential Care Communities—Pharmacy Partnership for Long-Term Care Program, December 2020–April 2021

Gharpure

et al. 2021

Journal of the American Medical Directors Association

View full text Add to dashboard Cite

Objectives: In December 2020, CDC launched the Pharmacy Partnership for Long-Term Care Program to facilitate COVID-19 vaccination of residents and staff in long-term care facilities (LTCFs), including assisted living (AL) and other residential care (RC) communities. We aimed to assess vaccine uptake in these communities and identify characteristics that might impact uptake. Design: Cross-sectional study. Setting and Participants: AL/RC communities in the Pharmacy Partnership for Long-Term Care Program that had 1 on-site vaccination clinic during December 18, 2020eApril 21, 2021. Methods: We estimated uptake using the cumulative number of doses of COVID-19 vaccine administered and normalizing by the number of AL/RC community beds. We estimated the percentage of residents vaccinated in 3 states using AL census counts. We linked community vaccine administration data with county-level social vulnerability index (SVI) measures to calculate median vaccine uptake by SVI tertile. Results: In AL communities, a median of 67 residents [interquartile range (IQR): 48-90] and 32 staff members (IQR: 15-60) per 100 beds received a first dose of COVID-19 vaccine at the first on-site clinic; in RC, a median of 8 residents (IQR: 5-10) and 5 staff members (IQR: 2-12) per 10 beds received a first dose. Among 3 states with available AL resident census data, median resident first-dose uptake at the first clinic was 93% (IQR: 85-108) in Connecticut, 85% in Georgia (IQR: 70-102), and 78% (IQR: 56-91) in Tennessee. Among both residents and staff, cumulative first-dose vaccine uptake increased with increasing social vulnerability related to housing type and transportation. Conclusions and Implications: COVID-19 vaccination of residents and staff in LTCFs is a public health priority. On-site clinics may help to increase vaccine uptake, particularly when transportation may be a barrier. Ensuring steady access to COVID-19 vaccine in LTCFs following the conclusion of the Pharmacy Partnership is critical to maintaining high vaccination coverage among residents and staff.

show abstract

State Regulatory Provisions for Residential Care Settings: An Overview of Staffing Requirements

Cited by 7 publications

References 3 publications

Variation in Licensed Nurse Staffing Characteristics by State Requirements in Residential Care

Variation in Licensed Nurse Staffing Characteristics by State Requirements in Residential Care

The Need to Include Assisted Living in Responding to the COVID-19 Pandemic

COVID-19 Vaccine Uptake Among Residents and Staff Members of Assisted Living and Residential Care Communities—Pharmacy Partnership for Long-Term Care Program, December 2020–April 2021

Contact Info

Product

Resources

About