In SLCR’s regulations related to ADC, there are specific regulations that indicate when an ADC would need to have a nurse perform a duty.  These include:

• Reviewing modified diets every 6 months (if modified diets are provided at the ADC) - can also be completed by a qualified dietician or the physician.
• Administration of medications/system of medication distribution or physician ordered treatments, and communication with physician related to medication/treatments. 19 CSR 30-90.050 (8) (D).

The ADC is also required to provide the appropriate type and number of personnel to care for persons in their ADC, in accordance with their plan of care.  If the plan of care required a service that would be recognized as a nursing service (such as tube feeding, colostomy care, etc) then the inspectors would review the participant’s plan of care to determine how this is being implemented. Otherwise, in an ADC that offers medical services, the nurse would need to be “available”, but that may or may not require him/her to be onsite at all times.  Again, whether a nurse is required to be physically onsite is dependent on the care needs and care plans of the individual participants you serve.