At the request of one of our members, LeadingAge WA reviewed the requirement for 24/7 RN coverage in Skilled Nursing (currently waived under the PHE) with RCS Policy Unit.  After much discussion, RCS has researched this question further and discussed the findings with Mike Anbesse. RCS has determined there is nothing to preclude a facility from using an MDS nurse (or Infection Preventionist, Staff Development) to meet the requirements under RCW 74.42.360(3)(a) and WAC 388-97-1080(3), as long as the registered nurse has some sort of oversight function and meets the five requirements:

1. On duty;
2. Provides oversight to staff;
3. Is on the premises;
4. Is quickly and easily available; and
5. Can provide necessary assessments and other direct care of residents.

This new interpretation should provide some regulatory relief to Skilled Nursing facilities, and we are pleased with this outcome.  RCS has stated that they will issue a Dear Provider Letter and Management Bulletin to officially explain the basis for this decision.

Questions?

Contact:

Laura Hofmann, MSN, RN – Director of Clinical and Nursing Facility Regulatory Services
c: 425-231-4804