[Code of Federal Regulations]
[Title 38, Volume 2]
[Revised as of July 1, 2003]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR51.130]

[Page 834]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
          CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS (CONTINUED)
 
PART 51--PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES--Table 
of Contents
 
                          Subpart D--Standards
 
Sec. 51.130  Nursing services.

    The facility management must provide an organized nursing service 
with a sufficient number of qualified nursing personnel to meet the 
total nursing care needs, as determined by resident assessment and 
individualized comprehensive plans of care, of all patients within the 
facility 24 hours a day, 7 days a week.
    (a) The nursing service must be under the direction of a full-time 
registered nurse who is currently licensed by the State and has, in 
writing, administrative authority, responsibility, and accountability 
for the functions, activities, and training of the nursing services 
staff.
    (b) The facility management must provide registered nurses 24 hours 
per day, 7 days per week.
    (c) The director of nursing service must designate a registered 
nurse as a supervising nurse for each tour of duty.
    (1) Based on the application and results of the case mix and 
staffing methodology, the director of nursing may serve in a dual role 
as director and as an onsite-supervising nurse only when the facility 
has an average daily occupancy of 60 or fewer residents in nursing home.
    (2) Based on the application and results of the case mix and 
staffing methodology, the evening or night supervising nurse may serve 
in a dual role as supervising nurse as well as provides direct patient 
care only when the facility has an average daily occupancy of 60 or 
fewer residents in nursing home.
    (d) The facility management must provide nursing services to ensure 
that there is direct care nurse staffing of no less than 2.5 hours per 
patient per 24 hours, 7 days per week in the portion of any building 
providing nursing home care.
    (e) Nurse staffing must be based on a staffing methodology that 
applies case mix and is adequate for meeting the standards of this part.

(Authority: 38 U.S.C. 101, 501, 1710, 1741-1743)