does anyone know mandatory nurse/patient ratio in skilled nursing facilities in CA

CoffeeRTC, BSN, RN · Jun 19, 2008

It will vary state by state...you can serch your states website and look at staffing in LTC. These numbers do not take into account the acuity of the residents. Just be cause they say it is okay, it isn't. The acuity varies so much from facility to facility.

I am in PA..our facility is 48 beds, I have 24 residents. 2-3 of them might be walky talkies and totaly independant. 1-2 could be hospice type, 3 or so could be "acute" and need suctioning, pain management, frequent wound care, 5 or six with behaviors ......you get the picture.

As far as end of life care.....most of the times, I feel unable to give what I should give to the family and patient. There really is no 1:1 care. We really try to do our best since for the most part..the resident is "one of our family". It helps when family can be in as much as posible for the minor things (sips of water, mouth care, basic repositioning).

So...even if the facility "has enough staff" according to the state regs, it still might not be enough depending on what type of residents they have.

As far as having family...my DH's aunt was in a LTC. She was A & Ox3 and would do her own complaining. I would let my FIL and MIL know what to expect and look for as far as basic nursing care. When she became confused, etc it was only for a short period before she passed.

TazziRN, RN · Jun 19, 2008

I know that LTCs do not come under the nurse-pt ratios that hospitals have to follow. I'm sorry for the loss of your parents.

Call the local ombudsman, s/he may be able to answer your question.

TheCommuter, BSN, RN · Jun 19, 2008

The answer to this question is very clear-cut ans simple. There are no mandated nurse/patient ratios that are applicable to skilled nursing facilities and extended care facilities (LTCFs). In fact, California is the only state that has any type of legally mandated nurse/patient ratio, and it only applies to acute care facilities.

CoffeeRTC, BSN, RN · Jun 20, 2008

Check this thread too

https://allnurses.com/forums/f86/ltc-state-staffing-tables-jan-2008-a-277097.html

suzanne4, RN · Jun 20, 2008

Sorry for your loss.

But as mentioned above, the ratio laws only apply to acute care beds, not LTC or skilled nursing facilities.

There is actually a state ombudsman that you contact concerning any issues that you had while your parents were patients if there were any.

MnemonicFanatic · Sep 4, 2009

I currently work in an LTC facility (in the midwest, not California). During the day/evening shifts, a unit will have one nurse (RN or LPN), one med-tech, and up to six nurses aides to care for approx. 35 residents. For the overnight, however, the staff on the same unit will consist of one nurse (either RN or LPN), and three aides to care for what sometimes can number up to 58 or so residents (some units are 'combined' for the overnight shift- one unit is regularly divided between two other units) Pulling the meds, passing them in the morning, checking blood sugars, flushing g-tubes, and the multitude of other procedures and treatments that need to be done can sometimes take three hours. Just don't add an emergency, or a fall, or any such other unplanned situation...and this isn't just when they are understaffed, this is a regular situation. The reason (excuse?) that's given is the standard "we aren't budgeted for more nurses/staff".

I'm sure this isn't the only LTC facility where this occurs, and unfortunately unless there are ratios set forth, it won't be the last. As michelle126 mentioned, acuity isn't taken into consideration. In theory, 35 residents may not be a problem to cover with only one nurse and three aides, but when you have three that are call bell happy and on a first name basis with the head-honcho, four that are high risk falls (and they will fall, guaranteed, just as you start the med pass:chuckle) several total cares, and a few hospice residents, and those 35 will suddenly seem more like 60 or seventy. Unfortunately, the only ones who ultimately suffer are the residents.