I, too, worked in a beautiful assisted living facility; it even had a whirlpool. Unfortunately the same staffing problems of other health care institutions plague this industry also. The whirlpool, therefore was rarely used because of lack of staff.
This is an industry where resident service (and therefore satisfaction) melds with health care. The one where I worked was private pay and expensive-about $2100/month. The nursing staff, consisting of one RN per shift and resident coordinators, are responsible for medication administration and monitoring for side effects, working with the resident's MD , and families, sometimes very closely, help with ADL's and even terminal care if the resident and their family wish them to remain there. We cannot do IV hydration, etc, because that would, according to law, take them to a higher level of care, require more staffing,etc and therefore become skilled care. We do, in my opinion, provide skilled care of these residents within our staffing crisis boundaries. The pace can be quite frantic at times when a terminal resident requires RN pain assessment and medication administration, is a high risk for falls, is weak and needs fed small frequent meals, toileting and hygiene and just being there, when she has 70-80 other residents with varying levels of care from independent to very confused wanderers and those needing psyche care, a new admit, call off for the next shift etc. The building is very large, so the walk usually includes stairs and being on two sides of the building at once.
Enter the shortage of resident co-ordinators (AKA aids), who give all the meds except insulin, coumadin and narcotics. They are not trained in pain management, communication techniques with the elderly, etc, so monitoring the staff is definitely a challenge. Most stay and average of three months due to the low pay and difficult work.
Also, may have to stay another shift if the RN relieving you cannot come in, and there is no one else that is able to come in- happens often.
All in all very satisfying work if the staffing level, again were addressed. Also more training is definitely needed for the aids who administer medication. I found once that and aid had been giving a large dose of comadin in the am and the RN was giving the same dose to the same resident in the pm. Very common episode and getting worse.
Sorry to go on , but once again, check staffing levels and policies etc, before those striped awnings and whirlpools sell you on these large beautiful buildings. I am curious to know about the above mentioned Alterra after the nurse has been working there a while.
I just quit this job, the one I loved the most, ever, because of dangerous staffing level, leaving the RN to do the aid work, and neglecting her own, dangerous levels affecting resident safety, most of which I did not address here, and toxic management-poor management that practices bullying and horizontal abuse. Baseline: residents not receiving safe level of care. ( and they pay out the wazoo.)