§ 23-17.5-32. Minimum staffing levels.
(a) Each facility shall have the necessary nursing service personnel (licensed and non-licensed)
in sufficient numbers on a twenty-four (24) hour basis, to assess the needs of residents,
to develop and implement resident care plans, to provide direct resident care services,
and to perform other related activities to maintain the health, safety, and welfare
of residents. The facility shall have a registered nurse on the premises twenty-four
(24) hours a day.
(b) For purposes of this section, the following definitions shall apply:
(1) "Direct caregiver� means a person who receives monetary compensation as an employee
of the nursing facility or a subcontractor as a registered nurse, a licensed practical
nurse, a medication technician, a certified nurse assistant, a licensed physical therapist,
a licensed occupational therapist, a licensed speech-language pathologist, a mental
health worker who is also a certified nurse assistant, or a physical therapist assistant,
social worker, or any nurse aide with a valid license, even if it is probationary.
(2) "Hours of direct nursing care� means the actual hours of work performed per patient
day by a direct caregiver.
(c) Commencing on January 1, 2026, nursing facilities shall provide a quarterly minimum
average of three and fifty-eight hundredths (3.58) hours of direct nursing care per
resident, per day.
(d) Director of nursing hours and nursing staff hours spent on administrative duties or
non-direct caregiving tasks are excluded and may not be counted toward compliance
with the minimum staffing hours requirement in this section.
(e) The minimum hours of direct nursing care requirements shall be minimum standards only.
Nursing facilities shall employ and schedule additional staff as needed to ensure
quality resident care based on the needs of individual residents and to ensure compliance
with all relevant state and federal staffing requirements.
(f) The department shall promulgate rules and regulations to amend the Rhode Island code
of regulations in consultation with stakeholders to implement these minimum staffing
requirements on or before October 15, 2021.
(g) On or before January 1, 2024, and every five (5) years thereafter, the department
shall consult with consumers, consumer advocates, recognized collective bargaining
agents, and providers to determine the sufficiency of the staffing standards provided
in this section and may promulgate rules and regulations to increase the minimum staffing
ratios to adequate levels.