Court Opinion

ID: 9596657
Source: CourtListenerOpinion
Date Created: 2023-08-22 00:51:59.830246+00
Date Added: 2024-06-11T09:39:32.925119
License: Public Domain

Ray Thornton, Justice, dissenting. On the issue of whether the staffing requirements apply to the director of nursing performing supervisory functions, and not providing direct care to patients, I respectfully dissent. The majority correctly states that the purpose of the legislation and the extra funding was to increase the number of direct care staff in the state’s nursing home facilities. In keeping with this purpose, the manual sets out the staffing requirements related to increasing direct care, and specifically provides that “RN’s can also be used to perform LPN duties with the same reporting requirements.” It was not necessary for this director of nursing to be on duty for direct care during her absences because there was a determination that the staffing requirements for CNA and LPN direct care assignments were completely filled throughout the quarter. I think that the emphasis upon meeting direct care requirements in accordance with the special language of the legislative funding for such efforts is further buttressed by the manual language setting out the staffing requirements for direct care: Only those hours spent performing direct care employee class (CNA, RN, LPN, Director of Nursing) related duties will be allowable in the determination of meeting the minimum staffing requirements. (Emphasis added.) The rule clearly states that the hours spent performing direct care related duties were the hours intended to be included in the calculation of the fulfillment of the staffing requirement. There was no showing that the director of nursing was required to provide direct care during the quarter when the absences occurred because all direct care responsibilities were fully met by CNAs and LPNs. In its holding, the majority fails to consider that the purpose of the Act was to increase direct care and, in my opinion, mistakenly interprets the language of the rule establishing staffing requirements only for direct care. This holding results in substantial unfairness to this facility and its patients, and therefore, I respectfully dissent. 94 S.W.3d 923