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Nursing Services, RN Case Manager Caseload and Patient Acuity System

Sets out how the Agency staffs licensed nurses around the clock, keeps every RN case manager at 12 or fewer assigned patients at all times, runs the patient acuity system California requires (including the annual reliability review by a committee appointed by the Director of Patient Care Services), assigns aides and volunteers by acuity, and handles contracted nursing and laboratory testing.

Preview: full text with a package
About this policy
Policy number
CA-HSP-NUR-01
Version
1.0
Main rule
22 CCR §74848
Library
California hospice · 60 policies
Category
Clinical tasks
Sections
23

In short

  • No RN case manager ever has more than 12 assigned patients. Check the caseload roster before you assign anyone.
  • Rate each patient's acuity at admission and at every plan of care update.
  • Heavy caseloads stay smaller: high-acuity points can stop new admissions before 12.
  • Tell the Director of Patient Care Services any time you think the acuity system or staffing is not working.
  • Report a significant change to the physician as soon as possible within 24 hours.

What's inside

23 sections. The full text comes with the One-time Policy Pack.

Full text with a package
  • Terms of Reference
  • 1. Purpose
  • 2. Scope
  • 3. Definitions
  • 4. Policy Statement (22 CCR §74848; 42 CFR §418.64(b))
  • 5. Nursing Services and Who Provides Them
  • 6. Caseload Limit of 12 Patients
  • 7. Patient Acuity System
  • 7.1 Required elements
  • 7.2 Acuity levels
  • 7.3 Acuity-adjusted caseloads
  • 7.4 Aides, volunteers and other personnel added by acuity
  • 8. Annual Review of the Patient Acuity System
  • 9. Contracted Nurses
  • 10. Laboratory Testing
  • 11. Nursing Documentation
  • 12. Responsibilities
  • 13. Records and Compliance Monitoring
  • 14. Staff Training
  • 15. References
  • 16. Related Policies and Forms
  • 17. Approval
  • 18. Revision History

An inspector may ask

  • Show me each RN case manager's caseload today. Has any RN case manager had more than 12 assigned patients at any time this year?
  • Describe your patient acuity system. How do you predict, assess and validate the nursing care each patient needs?

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