How to Determine Whether a LTC / SNF is Well Run - page 3

by vintagemother 9,896 Views | 45 Comments

Hello Nurses! I am taking the prereqs to apply to nursing school and recently became a CNA. I'd read and heard that working in a SNF / LTC facility was not desirable to most nurses and I (wrongly) assumed that people who... Read More


  1. 2
    Quote from CapeCodMermaid
    Warehousing? My residents all have a private room, breakfast anytime from 7 to 1030 in the morning, activites 10 hours a day...yep....sign me up for that kind of warehouse. Lots of my residents get better and go home. Those who stay with us for the remainder of their lives are very well cared for.
    What a warehouse! Just the other day one of my male Residents complained about "having to get up and have supper" . . . I proceded to tell him that he lives like a king. One percent of the world's population gets to have three squares cooked for them, served to them, taken away and cleaned up for them... bed made daily, weekly housekeeping of the entire efficiency apartment, and at his beck and call someone will come running!

    I would that the whole elderly population of the world had such a clean and safe way to grow old!
    lindarn and herring_RN like this.
  2. 6
    Quote from caliotter3
    ... I have found that every LTC facility I worked in, left much, much to be desired, both in terms of care provided to the residents, and workplace behavior of many employees, impacting on that care...
    After working in three national LTCs, this has also been my experience.

    Staff is overworked, poor staffing (especially nurses) based on needs (acuity), no supplies, equipment that doesn't function, and management that really doesn't care -- while verbalizing how much they're concerned for the welfare of "their" residents and staff.

    Now when auditors or corporate people are visiting... my what a change! Then, after these "visitors" depart, everything goes back to the status quo.

    Another "sad, but true" example in this industry.
  3. 2
    Quote from nguyency77
    I think one of the best ways to figure this out-- that I wish someone had told me before I had taken this job-- was to estimate how much it costs a resident to stay at that particular LTC/SNF and compare it to how well-staffed it is. My facility is extremely expensive to stay at; it is outrageous, and we don't have enough CNA to compensate for how much they pay to live here. I always feel really guilty when I can't provide complete care to residents the way I used to in school. I try to keep the place super clean, but I'm not always working. Some shifts leave it sparkling, while others leave a garbage dump.

    The truth is, the LTC corporate only cares about making more and more money. The blame for poor satisfaction always falls on us staff, although in reality the problem lies in poor staffing procedures. We don't have enough staff to care for the patients/residents the way corporate would like us to-- we can't fulfill their lies with inadequate staffing. I would not mind a pay cut-- take away my shift differential for all I care; just hire a few more CNA.

    It's not that people don't wanna work in LTC because they think they're too good for it; it's because there are too many that are BADLY run. It's a shame, because these places have the potential to be good for patients. Corporate just refuses to sacrifice a small profit for quality.
    "I always feel really guilty when I can't provide complete care to residents the way I used to in school."

    This is a very typical feeling among staff nurses in LTCs.

    "The truth is, the LTC corporate only cares about making more and more money."

    So very, very, very true. [/QUOTE]
    Not_A_Hat_Person and lindarn like this.
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    I feel sorry for all you people who have worked in bad nursing facilities. Maybe I've been lucky...maybe it's because I live in Massachusetts, maybe it's because I am the proverbial squeaky wheel. I've worked in many facilities. Some were old and needed a fresh look, some were brand new and upscale, some were modest. What I found in most if not all of them....caring staff AND caring administration. Do I get everything I want for the residents? No, but I do get everything they need. The people who own the facility I work for now had several choices when the medicare and medicaid funding was cut. They could lay people off or talk to the staff and see what worked for the majority. So they went building to building, got a concensus of opinions from the line staff--not the managers---and worked it out. The staff is treated well and respected for what they do. The owner and CEO come on a regular basis just to walk around and say hello. The CEO came in on July 4th. Most of YOU were probably at a cook out. My managers and I were all at work throwing a party for the residents and staff who had to work.
    Find a good place to work. They do exist.
    If you think LTC is so horrible...take a look and read what the hospital nurses are saying. They don't think they can give good care either.
    kmarie724, MedChica, deskbarn, and 4 others like this.
  5. 2
    Quote from CapeCodMermaid
    I feel sorry for all you people who have worked in bad nursing facilities. Maybe I've been lucky...maybe it's because I live in Massachusetts, maybe it's because I am the proverbial squeaky wheel. I've worked in many facilities. Some were old and needed a fresh look, some were brand new and upscale, some were modest. What I found in most if not all of them....caring staff AND caring administration. Do I get everything I want for the residents? No, but I do get everything they need. The people who own the facility I work for now had several choices when the medicare and medicaid funding was cut. They could lay people off or talk to the staff and see what worked for the majority. So they went building to building, got a concensus of opinions from the line staff--not the managers---and worked it out. The staff is treated well and respected for what they do. The owner and CEO come on a regular basis just to walk around and say hello. The CEO came in on July 4th. Most of YOU were probably at a cook out. My managers and I were all at work throwing a party for the residents and staff who had to work.
    Find a good place to work. They do exist.
    If you think LTC is so horrible...take a look and read what the hospital nurses are saying. They don't think they can give good care either.
    Capecod I have always said if I lived in your area I would love to work at your facility. I have also worked at many ltc over the years and found most of them well run
    Wise Woman RN and CapeCodMermaid like this.
  6. 0
    Indeed not all LTC facilities are awful.My facility I would have to say is somewhere in the middle. There are a lot of people where I work that describe how it was to work where they used to be. It seems the ones that miss their old jobs and now hate where we are were the ones that worked for the non profit facilities, mostly faith based around here.

    We have a "county home" that is supposedly "not for profit" but the employees that came from there said they still prefer it here. Government run doesn't seem to be the "best option" either. They have anywhere from 16-20 patients per 1 aid ratio and 50-60 patient to 1 nurse ratio for second shift there more nights than not. I was told there is SUPPOSE to be a second nurse with you for at least the first half of the shift but it is rare for that to really happen. That is why they left there and came where we are. I can't even comprehend how 1 nurse can give meds to 60 patients on time much less do all the treatments and paperwork etc on all of them in 8 hours! No wonder they ran away from the county home!
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    My best advice is to observe during feeding hours. You can tell alot about the care based on how they feed their dependent residents. Are they shoveling it in? Do they leave it running down their faces? Feeding takes alot of patience as well as compassion, and to me, also shows indicators about staffing as so many aides are rushing through to cover their halls.
    laborer likes this.
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    You can tell alot about the care given if the home calls it 'feeding hours'. I don't know about you, but in MY house we call it lunch or dinner.
    amoLucia, laborer, and BrandonLPN like this.
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    I guess that is exactly my point. When the staff IS shoveling in food and not interacting with the residents it no longer becomes a meal, it becomes "feeding time." These are the things I look for when observing a nursing home. I do a lot of clinicals in nursing home and I have found this mindset to be a pretty reliable indicator of the type of overall care they receive.

    Quote from CapeCodMermaid
    You can tell alot about the care given if the home calls it 'feeding hours'. I don't know about you, but in MY house we call it lunch or dinner.
  10. 4
    I, too, have often thought I should cross the border from CT into MA and seek out CapeCodMermaid and her facility.
    Wise Woman RN, SHGR, Debilpn23, and 1 other like this.


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