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Jun 05, 2008, 04:38 PM
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I am fortunate to work in a wonderful LTC facility with great staff. Don't get me wrong, we have our problems, but overall, I'm happy to be there. I think someone hit the nail on the head when they stated that things might get better as we age. Already I can see demanding family members having an impact. They're not always reasonable, but the more of them there are, the more attention they'll get. I truly believe that LTC facilities WANT to provide great care, but aren't reimbursed well enough to compete with acute care facilities for quality staff. CNA's must be state licensed to work in LTC, but not in a hospital. Also, the hospital pays a bit more, and take the cream of the crop....since acute care is reimbursed at a higher rate (rightly so, overall) they can afford to pay more. Plus, they don't have to pay an RN/LPN to do what a CNA can do. If our LTC facility is reimbursed at the MA default rate, it receives $139/day. That sounds like a lot, but when you add up all the staff it takes to care for our residents, we don't break even. Therefore Medicare rehab residents are encouraged (because the government pays more for them, up to $400+/day), but they're more acutely ill and require more skilled nursing time. Plus, all those admissions and discharges require mountains of paperwork. Sorry, I started to ramble...I took a thought and ran with it!
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