I am a new nurse turned Administrator. The types of patient we are seeing are exhausting!! I agree with you! The government doesn't give a hill of beans about our patients. My residents are getting sicker and the reimbursement is getting smaller, and their demands are high. Before you say administration doesn't care about not having enough staff , I too stay awake nights worrying about my patients. LTC is regulated more than hospitals in most states, yet they get the least support . I work the floor once in a while and see how hard the staff does work. I wish I had all the answers . I hope you consider all the back door expenses of running an operation. I know being an administrator now has really opened my eyes. So many things to comply with. So much money is spent on employees , benefits, training, licensing, OSHA, FLSA and a billion other agencies . Most people don't even consider. Hospitals can bill for supplies. Skilled Medicare units get a lump sum per day to provide all the care needs- including medications and all supplies. My facility also accepts Medicaid. We believe that everyone needs care. If my marketing person claims we run the Hilton, I'd fire her in a minute! People need to understand that we are human beings caring for human beings. The public is so educated in what our jobs are, they need to educated on how to treat people who care for your loved one!