(a) A center's total staffing for nursing services must be maintained, at a minimum, in the following ratios but at no time must there be less than one staff member on duty per three minors receiving nursing services from a center. If only one staff member is on duty, that member must be an RN.
(b) The staffing ratio is based on the number of minors on the center's actual census that are receiving nursing services from the center.
(c) A center must not include direct care staff who qualify under subsection (b) of §15.409 of this division (relating to Direct Care Staff Qualifications) in the staffing ratio until the staff complete the training program and demonstrate competency as described in subsection (b)(3) of §15.409 of this division.
(d) A center must maintain documentation to support compliance with this section and §15.803 of this chapter (relating to Census). Documentation must include:
  (1) each change in the number of minors on the center's actual census that are receiving nursing services from the center; and
  (2) the increase or decrease in the number of RNs, LVNs, and direct care staff in accordance with this section as changes in the number of minors on the center's actual census that are receiving nursing services from the center occurs.
Attached Graphic

Source Note: The provisions of this §550.410 adopted to be effective September 1, 2014, 39 TexReg 6569; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1875