CMS SOM App. A, Tag A-1703

24 hours each day…

Interpretive Guidelines §482.62(d)(2)

There must be an RN immediately available 24 hours each day, 7 days a week.

Refer to §482.23 Tag A-0385 for more comprehensive details for this requirement.

Survey Procedures §482.62(d)(2)

• Interview the Director of Nursing Service. Request the following items:

o Organizational chart(s) for nursing services for all locations where the

hospital provides nursing services;

o Job or position descriptions for all nursing personnel including the

director’s position description.

• Select at least one patient from every inpatient care unit. Observe the nursing

care in progress to determine the adequacy of staffing and to assess who is

providing care to ensure the delivery of care is provided by staff who are

functioning within their scope of practice. Other sources of information to use in

the evaluation of the nursing services are: nursing care plans, medical records,

patients, family members, accident and investigative reports, staffing schedules,

nursing policies and procedures, and QAPI activities and reports.

• Interview patients and family members or significant others involved in the

patient’s care for information relative to the delivery of nursing services.

• Interview staff to determine adequacy of nursing staffing. Determine if there is

immediate availability of an RN 24 hours a day.