resident/staff ratios

Specialties Geriatric

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Specializes in long-term-care, LTAC, PCU.

I was just wondering what everyones RN, LPN, CNA to resident ratios are. The facility that I just resigned from sometimes had one LPN or RN on a 46 bed unit, with never more than 4 CNAs and a lot of times, only 3. This LPN is responsible for all medications, treatments, and documentation for this unit, as well as being "in charge". I don't think that's in any way a safe situation, so I resigned. I guess it's pretty common practice at this facility to do that to and LPN or RN. They have not done it to me yet, but I'm not going to give them the opportunity to do it either. Am I just being a baby or does this sound rediculous to anyone else?:no:

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Specializes in Gerontology, Med surg, Home Health.

Did you work days? Seems like too many people on a day shift but doable for nights or maybe evenings depending on the kinds of residents.

LTC won't be getting any easier any time soon. People are getting older and sicker and there is less and less money from the government.

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The place where I work usually only staffs one RN/LPN to about 35 residents at the most. When working with more nurses at a time, the ratio is usually 1: 15.

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Specializes in SNF-LTC; Gero-psych.

Where I am now we have 3 halls, LPNS work 12 hr shifts and CNAs work 8 hr shift

South, 56 beds, 2 LPNS on day and night, one on short one on long 28 beds each, 3-5 CNA's on 1st shift, 2-4 CNA's on 2nd Shift, 2 CNA's on 3rd

Alzh Dx Unit - 22 beds. 1 LPN on Day, and Night, 2 CNA's 1st shift, 1-2 CNA's 2nd shift, 1 CNA 3rd shift

East, 51 beds, 2 LPNS on Day and NIGHT, sometimes just 1 on NOC, 26 beds on 300 and 25 on 500, 3-5 CNA's on 1st shift, 2-4 CNA's on 2nd Shift, 1-2 CNA's on 3rd

RN 1 for South, 1 for East/Alz unit on dayshift 0 for NOC

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Specializes in long-term-care, LTAC, PCU.

So, does anyone have an idea of what the nurse/resident are supposed to be? I mean, is there a bare minimum of staffing that is mandated by law? Where could I find this information?

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Wow, I feel so fortunate, We have two halls, south and west. On south we have the capacity for 18 residents, currently we have 17. On West that is skilled we have the capacity for 14 patients and currently have 9 (very unusual) but I like the break. I work in a small town in Northen Michigan and I had 5 weeks of training before I was on the floor by myself. I have been reading a lot of posts, and realize how lucky I am. Rhonda

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So we have one nurse for each hall, and two cena's for each hall. And I (LPN) help the cena's whenever I can. I wipe butt's, help people get ready for bed, I just want the residents to be treated how I would want to be treated. We are one big happy family.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
So, does anyone have an idea of what the nurse/resident are supposed to be? I mean, is there a bare minimum of staffing that is mandated by law? Where could I find this information?
No legally mandated nurse/resident rations exist for LTCFs anywhere.

The only state that has mandated nurse/patient staffing rations is California, and they are applicable only to acute care facilities such as hospitals.

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Specializes in Gerontology, Med surg, Home Health.

The regulations in Massachusetts for LTC facilities state there must be 'adequate' staffing to meet the care needs of the residents. Apparently every facility has a different definition of adequate.

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In Indiana they have nurse hours/resident but I think it is to compare facilities and not "regulation". I am not sure what it means as far as nurse to # residents though. I do know that it is the average for the whole day and can include anyone with a license (RN/LPN) but not the DON. Even the unit supervisor who sits at the desk, auditing charts, & doing new orders, etc is counted in that ratio.

Where I work there are 3 halls - Alzhiemers hall has 1 LPN & 2 CNA/20 residents --> Days & evenings, director is there only on days. North hall has 1 LPN & 3 CNAs/32 residents; South has 1 LPN, 1 QMA & 3 CNAs/ 38 residents --> Days & evenings, plus a nurse supervisor that mans the desk. Nights has 1 LPN/2 CNAs in each hall and the LPNs share the Alzeimers unit for 42 or 48 residents --> no nurse supervisor. We have something like 1hr.24min. nurse hours per resident & we have 90 residents total.

The facility I did my Geri clinicals was quite large. It had 4 halls, 2 were for skilled nursing, 1 was transitional, and 1 was LTC/ALC. We were assigned to the LTC/ALC hall which had 1 LPN & 2 CNAs/20 residents. I am not sure what the ratios were for the other 3 halls. They also had a Rehab center attached but it was pretty separate from the nursing home side.

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Specializes in Geriatrics.

I'm not sure about the other stations, but I work station 2 the middle one and we have 37 residents (I'm talking evening shift), me in charge/RN, a med tech to pass pills, and 4-5 CNA's. I think station 1 has like 45 residents or so and they get a charge nurse, med tech, and 5 CNA's. Then the littlest station, 3, has about 22 residents and they get a charge who also passes their pills and 1-2 aides. Then they have a residential care too and I have never stepped foot in that side of the building so I don't know.

The last place I worked at staffed according to "fire code"...I would wager a guess that the Division of Aging would know more about this.

Blessings, Michelle

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When I posted before, I hadn't worked a shift outside of training because I was hired PRN. Well, I did this past weekend (11/22 & 23). My training experience was horrible, mind you, and I almost decided not to work there. I only trained on days, knowing that I potentially could work any shift. Training consisted of 3 days - but I asked for 1 more, got 2, because (I realistically thought) I didn't know when they would need me again. I finished training mid Oct. - so I had 1-1/2 months until I worked again. They've had some staffing changes so I they finally needed to use me.

Anyway, weekend shifts are killer 12 hrs long. On days, North (32 beds) & South (38 beds) halls has 1 LPN charge, 3 CNAs, no QMAs & the Alzheimers unit has 1 LPN charge, & 2 CNAs. There is an RN supervisor maning the desk.

I tried to do as much as I could on day 1 but ended up so frustrated with myself because I was slow, don't know the residents, and am a 1st time nurse so I needed lots of help which frustrated me even more. On day 2, we developed a system where I just did pills all day (2 killer med passes ) and my spvsr did everything else - BS, insulins, treatments, assessments, VS. We shared the charting at the end depending on what we did/saw. Day 2 it was much easier to keep track of where I was but I still don't know how I'll be able to fit it all in. They tell me I'll get faster with meds but not to expect to get it all done. To me that is not acceptible. Right now I am concentrating on learning the residents and speeding up my med pass and get a system in place to make multi-tasking easier. It drives me CRAZY that I have trouble keeping track of more than a couple things at a time. But I am so overwhelmed with volume of work that needs to be done.

For the first time, I started second guessing my decision to be a nurse. All I hope is that once more baby boomers start needing full time care and families get involved, that they'll start screaming for a change because no one is listening to the nurses - IMHO.

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