Re: Sleep overs Originally Posted by Nascar nurse 
In my state, you can be a SNF certified medicare building without being a SNF certified medicaid building. If you don't have the medicaid certification you can not take a medicaid person.
This could sound like a good thing financially, but you run the risk of a very unstable census. Once skilled needs are complete, the resident is required to pay privately or discharge from the facility. Makes for wild ride with census, budgets, staffing, etc.
If the facility is certified by both, then we can not discriminate based on payor source either.
we arent certified for medicaid.
they've batted back and forth about reapplying for that certification but we are more profitable as a short stay rehab so, for now anyway, we are not getting that certification. we make a lot of money for the company.
but you are right about the census. it's a roller coaster ride sometimes! and when we get low, we take ANYTHING. lucky for us, our census stays up there where it should be. we stay at about 95% full all the time.
it's the first non-medicaid facility i have ever worked for. i like it though. but dang! it sure is fast paced! it's nothing to get 6-8 admits with5-6 discharges a day! not to mention constant md orders, labs, etc.
we have a doc in facility 4 days a week or else it couldnt be done.
people now a days do not understand that a doc is supposed to only see them once a month in SNF. they expect the md to round on them like they do in the hospital *sigh*
we are a good team...all of us in nursing. it takes us all to get it all done every shift. as the RN, even on the weekends, i am constantly on the phone with the docs, doing IVs,etc. i try to do everything that has to be done because it takes the nurses on thefloor their whole shift just to get the meds out, families talked to constantly and charting done. we've all worked together for years so we are a pretty good team and i wouldnt trade that for the world.
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