There is so much turnover in LTC that I'm always surprised when I visit a facility (to evaluate a prospective resident, or assess one of our own for his/her readiness to return home) and find the same management people I spoke with the last time I was in their building.
Right now I'm consulting in a sister facility whose survey was 118 typed pages of horror. Their nurse had only been on the job for 3 months when the surveyors came in, and they barbecued her---I'm actually amazed that she didn't quit. It's kind of sad that people come into AL nursing thinking "Oh for Pete's sake, it's assisted living, how hard can it be?" and then they FIND OUT how hard it is by getting skewered in the survey process. This particular nurse came from a home health/hospice background, so she really doesn't know what she's doing....and what's worse, there is no sense of urgency in working on the plan of correction on either hers or the facility administrator's part.
So now the VP of clinical operations, a DNS from another building, and I were going through the residents' charts, which are an unholy mess......while the nurse and the administrator BOTH were out doing move-in assessments. Really??!
They aren't doing a decent job of caring for the residents they already have; I can't imagine the State allowing them to move anyone else in at this point. Not with med aides who leave the diabetic MARs in the med room while giving insulin because "I know all of their sliding scale insulin orders"
and upgrade mechanical-soft diet textures to "regular" without either notifying the nurse or MD "because the resident wanted it". YAAAAAAAAAAAACCCCCCCCCCK!!!!