SNF units at hospitals

RN&mom · Nov 16, 2013

I think all of us are "real nurses" and those that think they're better than others because of where they work really need to grow up! I have worked a SNF facility and now work a mixed LTC/SNF. I love my job and work very hard every day!!! Lots of complicated pts all the time, it's not easy... A hospital near me recently downsized and we were the only place hiring at the time so we got one of the ICU nurses. I love her but she's the first to admit, this is tough nursing! And she's been a nurse for 40 years! She recruited 2 of her ICU friends to come work for us but only one of them stayed, she couldn't keep up and knew it so she resigned. Too bad because I really liked her... It's not because the work load is impossible or anything but as you know it's a different way of nursing, and it's not for everyone. I'm proud to be charge nurse at my facility and am there because I want to be not because I couldn't get a hospital job. I think that's a huge misconception among other nurses, they don't realize most of us want to be there and there are a lot of technically challenging pts in SNF & LTC.

BrandonLPN, LPN · Nov 17, 2013

"Real nurses" is as much of a nonsense term as "Real Americans". All Americans are real Americans by definition and all nurses are real nurses.

And 7:1 max ratio for skilled nursing? If your hospital is really being reimbursed at SNF levels, then your floor must be a horrible money pit for the place.

LadyFree28, BSN, LPN, RN · Nov 17, 2013

"Real nurses" is as much of a nonsense term as "Real Americans". All Americans are real Americans by definition and all nurses are real nurses.

THIS

Sometimes the need for selective hearing and vision is needed to help enjoy this business.

If you enjoy it nurse ON....

Depending on the hospital/health system, they may have a SNF so the have a few beds authorized before they patient has placement-they are still too unstable or so medically complex they cannot go into LTC.

There is a health system in my area that has a SNF but they also have a LTCAH; they stay in the SNF based on complexity and stability; or overflow for their LTCAH.

I work in a LTC that has a short stay unit; pretty much like a mini hospital. Their ratio is 10:1 for one hall and the other hall is LTC with 30:1.

BrandonLPN, LPN · Nov 17, 2013

I guess I don't understand reimbursement. If the OP's unit is billed at SNF levels, but they're staffed at med/surg levels.... seems like a money-loss scenario. I always thought the reason SNFs could make a profit with less funding was precisely because they had far fewer staff per patient.

nolanurse88 · Nov 17, 2013

I don't quite understand the reimbursement part myself.. I just know only certain patients qualify for SNF depending on insurance like medicare. They are normally transferred from med-surg to SNF for either wound care, IVAB, or PTOT and then discharged to either home or LTC. The 7:1 pt. ratio is really a lot on our unit based on higher acuity level and most of our patients cannot do for themselves.

I try not to let much bother me at this point with other nurses making those comments because they really just have no clue as to what we do.. I know where I'm at I'm always seeing and learning something new and also using the same skills as a nurse on a med-surg unit, minus a few things, we haven't had a chest tube patient but I wouldn't be surprised if they would send us one. That's what matters to me most because I do plan on transferring when I receive my RN degree.

Thanks for everyones replies.

slicksGIRL · Nov 17, 2013

Hi! I am an LVN in SoCal and the hospital I work at has a long term type care. Our patients have been with us for a while.. So when we go on the floor we are already familiar w the patients. Our ratio is 5:1 mornings and 6:1 at night max. We run on a 12hr shift and us the LVNs are in charge of everything for our assigned patient. Meaning, trach care, gtube feeding, foleys, pt care, tx and meds. We have one RN on duty every night to delegate and supervise as well as handle all the IVs. I never quite understand how that works in a hospital setting cus we have a ccu, peds, maternity, er and a psych unit. And a lot of the LVNs from different floors tells is how hard we work cus for other depts.. They don't really do anything.

ktwlpn, LPN · Nov 17, 2013

All three of my local hospitals closed their SNF units within a few years of opening them. They did not turn into the cash cow they were expected to be. Most local LTC's are now opening SNF units and are bring in significant revenue. In my opinion it works best when you set an entire unit aside for SNF and train and staff it accordingly . I've seen LTC's who scattered those patients within the population and patient satisfaction goes way down.

nolanurse88 · Nov 17, 2013

@ slicksGIRL that's exactly how ours is we are responsible for the same things which is everything. We do have a variety of RNs and LPNs though and whenever we have an IVP or blood to hang is when we go to our charge nurse. Our patients normally aren't there longer than 2 weeks but occasionally we'll have that 1 pt that is with us for months.

Tired nurse · Mar 17, 2023

It is now 2023 and every nursing home has turned into a rehab center with direct admits from ICU. All the nurses are still LPNs except the manager who never sets foot on the floor. They have pushed high acuity pts onto the long term care halls and increased pt loads. The younger pts are mean to the old folks and self centered and very rude to staff and get mad because they want more attention but this is not a hospital every nurse is overwhelmed with at least 30 pts. But no one in management even cares. So stop putting down LPNs they are wonderful nurses!