(a)

1. (1) To effectuate the intent of this part, the assisted living facility shall develop a staffing plan to ensure sufficient personnel/staff/employees are available to meet the needs of the residents.
2. (2) A facility shall meet minimum staffing ratios set forth below at all times, and shall utilize sufficient staff to meet each resident’s particular direct care needs as agreed to and specified in the resident’s services plan portion of the occupancy admission agreement.

(b)

1. (1) In facilities with sixteen (16) or fewer residents, the facility administrator may be counted as direct care staff while still acting as, or performing the duties of, administrator.
2. (2) In facilities with more than sixteen (16) residents, the facility administrator may be counted as direct care staff on shifts on which he or she is not performing or required to perform the duties of an administrator.
3. (3) The administrator must meet all licensing or certification requirements for the duties that the administrator is performing.

(c)

1. (1) The facility shall have as many personnel/staff/employees awake and on duty at all times as may be needed to properly safeguard the health, safety, or welfare of the residents.

2. (2) For purposes of this part, “on duty” means that the individual is:

   1. (A) On the premises of the facility;
   2. (B) Awake; and
   3. (C) Able to meet residents’ needs.
3. (3) At least one (1) administrator, on-site manager, or a responsible staff person shall be on the premises twenty-four (24) hours per day.
4. (4) Residents shall not be left unsupervised, as that term is defined in 20 CAR § 410-803(b)(1)(A).

5. (5)

   1. (A) The following are the required minimum staff/resident ratios and other staffing requirements.
   2. (B) Required on-site staff/resident ratios based on current resident census are for large and small facilities:

      # Residents	Direct Care Staff Required PerShift
      	Day	Evening	Night
      1 – 16	1	1	1
      17 – 32	2	2	1
      33 – 49	2	2	2
      50 – 66	3	2	2
      67 – 83	4	2	2
      84 – above	5	3	2

   3. (C) Each staff person on duty may be counted as direct care staff even if they are currently involved in housekeeping, laundry, or dietary activities as long as universal precautions are followed.

(d) Staff requirements are as follows:

1. (1)

   1. (A) For facilities with sixteen (16) or less residents, the facility shall have an electronic system, such as pagers or cell phones, to contact relief staff if the on-duty staff person must leave the facility for an emergency or other reason.
   2. (B) A staff person who must leave the facility shall utilize the system to obtain staff relief, and shall not leave the facility until the relief person appears at the facility.
   3. (C) For facilities with more than sixteen (16) residents, a relief staff person must be available to relieve staff and to cover if a staff person must leave the facility in an emergency or for any other reason;
2. (2) The staffing schedule must be posted in the facility; and
3. (3) The Office of Long-Term Care may, in its sole discretion, grant waivers to staffing standards in situations where the facility demonstrates an ability to adequately meet service requirements with fewer staff.