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SNF Transitional Care Unit: Staffing Ratios



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Aug 08, 2009 09:06 AM

SNF Transitional Care Unit: Staffing Ratios

by KdubRN

I am an ADON at a skilled nursing facility and am specifically managing the Transitional Care Unit at our facility. Our nurses are constantly saying that they are understaffed and our corporate admins are always saying, "no, you're over-staffed." I have searched the literature and have found very little in regards to guidelines on best practice. I would like to know how you all staff your TCUs and include some of the following information so we can all help each other and do a little informal research:

1. Nurse:Patient ratio for 1st shift (day shift if 12hr shifts)
2. Nurse:Patient ratio for 2nd shift
3. Nurse:Patient ratio for 3rd shift (night shift if 12hr shifts)

4. Nursing Assistant:Patient ratio for 1st shift
5. Nursing Assistant:Patient ratio for 2nd shift
6. Nursing Assistant:Patient ratio for 3rd shift

7. Number of TCU beds
8. Typical case load picture (Number of GTs, IVs, TPN, trachs, average age of patients, dementia, etc. for unit)
9. Staff makeup (number of RNs, LPNs, etc.)
10. Layout of unit (square-shaped, star-shaped, hallway, etc.)
11. Do you have similar complaints and problems? How have you solved them?
12. In which state are you working?


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1 Comment
No. 1
from noc4senuf
Old Aug 13, 2009, 04:32 AM

Default Re: SNF Transitional Care Unit: Staffing Ratios
Wow... what a load of questions!

First of all, my TCU is 28 beds and shaped in an "L".

I have 2-3 aides on days and PM's with 1-2 aides on nocs, depending on the census or acquity. Typically it is a ratio of 1:7.

As for nurses, up to 13-15, I use just a nurse and after that I add a TMA. Depnding again on the acquity I add a second nurse when the census gets closer to 20.

One nurse manager and a HUC.

We have lots of ortho cases (hips, knees), CVA's, medical, some hospice... the mix changes all the time. Tube feeders, occas IV's and or TPN's, wounds.

THe staff that work this unit love it due to the continual changeover of resident.
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