1. (a) Implementing twenty-four-hour-based staff scheduling. Nursing facilities subject to the Nursing Home Care Act and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) with seventeen or more beds may implement twenty-four-hour-based staff scheduling consistent with the requirements established by law at 63 O.S. 1-1925.2(B)(5).
2. (b) Loss of twenty-four-hour-based staffing privileges. The Department shall require a facility to maintain the shift based staff-to-resident ratios provided in 63 O.S. 1-1925(B)(3), if the facility has been determined by the Department to meet the disqualifying criteria in 63 O.S. 1-1925.2(B)(6), relating to staffing levels, fraudulent Quality of Care reports, or findings of substandard quality of care as a result of insufficient staffing. For intermediate care facilities for individuals with intellectual disabilities, loss of eligibility shall include findings of non-compliance with the Condition of Participation at 42 CFR 483.430 (2011), Facility Staffing.
3. (c) Eligibility requirements following loss of twenty-four-hour-based staffing. Prior to a facility resuming eligibility for twenty-four-hour-based staffing privileges, the Department shall require that the facility maintain the shift-based, staff-to-resident ratios in 63 O.S. 1-1925.2(B)(3) for at least three (3) months and has corrected any deficiency described in (b) of this section.
4. (d) Right to Appeal. Facilities shall have the right to appeal and to the informal dispute resolution process with regard to penalties and sanctions imposed due to staffing noncompliance. [63:1-1925.2(E)].
5. (e) Quality of Care Report Requirement. Staffing hours reported to the Oklahoma Health Care Authority shall be submitted electronically through OHCA's Quality of Care (QOC) portal.
6. (f) Twenty-four-hour-based staffing in intermediate care facilities for individuals with intellectual disabilities (ICFs/IIDs) with sixteen or less beds. ICFs/IIDs with sixteen or less beds shall be authorized to use the twenty-four-hour-based staffing requirements specified in (c) and (d) of 42 CFR 483.430 (2011).
7. (g)

Shift-based ratios for noncompliant facilities. This paragraph implements 63:1-1925.2(F)(4).

1. (1) When the provisions of 63:1-1925.2(F)(1) are in effect, pursuant to 63:1-1925.2(B)(7), the following minimum direct-care-staff-to-resident ratios for non-compliant facilities shall apply in addition to other state and federal requirements related to the staffing of nursing facilities:

   1. (A) From 7:00 a.m. to 3:00 p.m., one direct-care staff to every five residents,
   2. (B) From 3:00 p.m. to 11:00 p.m., one direct-care staff to every seven residents, and
   3. (C) From 11:00 p.m. to 7:00 a.m., one direct-care staff to every thirteen residents.

2. (2) When the provisions of 63:1-1925.2(F)(2) are in effect, pursuant to 63:1-1925.2(B)(7), the following minimum direct-care-staff-to-resident ratios for non-compliant facilities shall apply in addition to other state and federal requirements related to the staffing of nursing facilities:

   1. (A) From 7:00 a.m. to 3:00 p.m., one direct-care staff to every five residents,
   2. (B) From 3:00 p.m. to 11:00 p.m., one direct-care staff to every six residents, and
   3. (C) From 11:00 p.m. to 7:00 a.m., one direct-care staff to every eleven residents.

3. (3) When the provisions of 63:1-1925.2(F)(3) are in effect, pursuant to 63:1-1925.2(B)(7), the following minimum direct-care-staff-to-resident ratios for non-compliant facilities shall apply in addition to other state and federal requirements related to the staffing of nursing facilities:

   1. (A) From 7:00 a.m. to 3:00 p.m., one direct-care staff to every four residents,
   2. (B) From 3:00 p.m. to 11:00 p.m., one direct-care staff to every six residents, and
   3. (C) From 11:00 p.m. to 7:00 a.m., one direct-care staff to every eleven residents.

Added at 21 Ok Reg 987, eff 3-30-04 (emergency)

Added at 21 Ok Reg 1317, eff 5-27-04

Amended at 36 Ok Reg 1748, eff 9-13-19

Amended at 37 Ok Reg 1453, eff 9-11-20