employ a registered professional nurse who has received training in adult education and gerontology. . (b) Medicaid (1) In general Paragraph (1) of section 1919(d) of the Social Security Act ( 42 U.S.C. 1396r(d) ) is amended by inserting after subparagraph (C) the following new subparagraph: (D) Nursing management personnel (i) In general A nursing facility must employ nursing management personnel in accordance with this subparagraph. (ii) Director of nursing services A nursing facility must employ a registered professional nurse to serve full-time as the director of nursing services of the facility. Such director of nursing services shall be responsible for determining the number and types of nursing personnel needed to sufficiently meet the nursing needs of the residents of the facility (as required under subsection (b)(4)(C)). (iii) Assistant director of nursing services A nursing facility must employ a registered professional nurse to serve full-time as the assistant director of nursing services of the facility, except that in the case of a nursing facility that has fewer than 100 beds, such facility may employ a registered professional nurse to serve part-time as the assistant director of nursing services of the facility. A registered professional nurse who serves as the assistant director of nursing services of a nursing facility may also serve as a supervisor for direct clinical nursing care for such facility. (iv) Director of in-Service education A nursing facility must employ a registered professional nurse to serve full-time as the director of in-service education of the facility, except that in the case of a nursing facility that has fewer than 100 beds, such facility may employ a registered professional nurse to serve part-time as the director of in-service education of the facility. In carrying out the previous sentence, a nursing facility must, to the extent practicable and appropriate, employ a registered professional nurse who has received training in adult education and gerontology. . (2)