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Traditionally, our camp had no licensed staff on ground full time for 200 campers and 40-70 staff members. For many years, it was a single unlicensed employee, but for the past 13 or so years there were 2-3 unlicensed full-time staff.
To meet ACA requirements during that time, a volunteer RN would come out once a day for consultation, answer questions, notify camp admin of any glaring errors. However, the volunteer may change each day, could stay as long or as short as they wanted, and weren’t technically responsible for the general operations, just consultation.
The past 2 summers, we’ve had an two RNs on staff who work portions of the week. A few days they are both there at the same time, but most days, there is one RN. They have 1-2 full-time unlicensed support persons (or 3-4 part-time ones).
For perspective: We are in TN, so there are zero rules about healthcare staffing at summer camps, unfortunately. It is a residential program for general population children, no special health focus.