Registered Nurse Immediate Availability to Patient Care Areas

For hospitals that use Joint Commission accreditation for deemed status purposes and for distinct part rehabilitation and psychiatric distinct part units in critical access hospitals, a note has been added to the requirement found at NR.02.03.01 EP 7 regarding the immediate availability of a registered nurse. What patient care areas are included in this ‘Note’?

Any examples are for illustrative purposes only.

While the requirement regarding the provision or supervision of care delivery by a Registered Nurse (RN) is not a new requirement, the ‘note’ clarifies CMS’s expectation regarding the availability of an RN.

For hospitals that use Joint Commission accreditation for deemed status purposes, NR.02.03.01 EP 7 applies to all inpatient units, departments and locations in which the provision of nursing care occurs. This includes any outpatient locations in which surgical services are provided as the Conditions of Participation require that the hospital’s outpatient surgical services must be consistent in quality with the hospital’s inpatient surgical services. The Emergency Department(ED) would also be included as patients may be boarded in the ED while awaiting admission or transfer.

For distinct part rehabilitation and psychiatric distinct part units in critical access hospitals, NR.02.03.01 EP 7 applies only to these inpatient units. The requirement does not apply to clinic settings, such as Family Practice, Internal Medicine, etc.

Although the term ‘immediately available’ has not been formally defined, an RN would not be considered ‘immediately available’ if he/she was working on more than one unit, building, floor in a building, etc, at the same time.

Small organizations and those located in rural areas may consider contacting their state’s CMS office regarding a waiver (42 CFR §488.54(c)) option.

Click here to view the full text of the revised requirements for 2019.
 
Last updated on June 29, 2020
Manual: Critical Access Hospital
Chapter: Nursing NR

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