CMS SOM App. A, Tag A-0397

nursing personnel in accordance with the patient’s needs and the specialized qualifications

and competence of the nursing staff available.

Interpretive Guidelines §482.23(b)(5)

A RN must make all patient care assignments. The director of the nursing service and the

hospital are to ensure that nursing personnel with the appropriate education, experience,

licensure, competence and specialized qualifications are assigned to provide nursing care for

each patient in accordance with the individual needs of each patient.

Survey Procedures §482.23(b)(5)

• Review the nursing assignments. Did an RN make the assignments? Determine that the

assignments take into consideration the complexity of patient’s care needs and the

competence and specialized qualifications of the nursing staff.

• Ask a charge nurse what considerations are necessary when making staff assignments.

Answers should include:

o Patient needs;

o Complexity of patients;

o Any special needs of individual patients;

o Competence of nursing personnel;

o Qualifications of nursing personnel;

o Education of nursing personnel; and

o Experience of nursing personnel.