Assisted Living Audits

Bella'sMyBaby · Sep 2, 2010

I've heard this scenario before with Assisted Living Facilities.

The thinking is that since it's Assisted Living, residents take care of themselves.

And since it's an AL Facility, the staffing is usually lower than it is in LTC.

Talk to your Administrator about additional staffing. :nurse:

Long Term Care Columnist / Guide · Sep 2, 2010

I hate to be the bearer of bad news, but talking to the administrator about additional staffing in ALF is almost always an exercise in futility. One reason is, they are almost never nurses themselves and thus have NO clue about what you do all day; another reason is the profit margins are much slimmer than one might think, oftentimes because the companies that run these places spend a fortune on promoting themselves and their facilities. One facility I worked at gave out tons of plastic water bottles, thermal coffee cups, tote bags, pen/pencil sets, even nail-care kits, all with the company logo on them.......while the caregivers toiled at barely above minimum wage, without raises or benefits for almost two years. Shows you where the upper management's minds are at.

You should, however, ask for more hours for yourself. Personally, I've done part-time for ALFs in the past and was terrified for my license; once I went to full-time, I had adequate time to delegate properly and follow up on resident issues. Time management is, of course, of the utmost importance even if you are granted FT hours; unfortunately, this means you will probably have to give up some of the hands-on stuff and delegate it to your staff or get a home-health agency on board as appropriate.

You also need to know that the RN role in assisted living has changed over the years into something that is much more of an administrative function than anything else. You are the manager of care, not the provider---that's what care staff, home health, hospice, and other ancillary services are for---and for a lot of ALF nurses, that's the sticking point. It was with me, too; I didn't go to nursing school just to sit behind a desk and push papers or do audits. But that's what the role requires nowadays, and I don't think it's going to go backwards anytime soon.

Bottom line: you'll either have to make your peace with the managerial aspects of assisted living nursing, or find something else that's more patient-care oriented. Me, I went back to the bedside and haven't regretted it. I wish you the best, whatever you decide to do.

Nurseop · Sep 3, 2010

Thank you so much for your response. I did go to work today with the idea that I would give their audit a try. I really didn't see a need for me to do it as the RCC had done it two weeks ago. I did have a lot of questions about the audit which no one seemed to be able to answer, so I went home and thought about it. It seems that is what RNs do. So I looked at a few areas and then reported to the appropriate people that this and that are missing and they were happy. I told them I was giving the answer to the test before it happened. They loved it. Obviously the audit was not well understood and therefore did not serve it's purpose. Maybe that's where I come in.

I've been a nurse for over 30 years with lots of bedside experience. I've worked in Assisted Living for two years and am very good at managing resident care. I just need to get better at managing the people who deliver the care and the PAPERWORK!

Thank you so much again for your reply because I was so frustrated and angry. There is nothing like talking to a real nurse and I just don't get that anymore, although we are thinking of starting up a group of us in our community.

Havin' A Party!, ASN, RN · Sep 17, 2010

I hate to be the bearer of bad news, but talking to the administrator about additional staffing in ALF is almost always an exercise in futility...

I second this emotion.

Their biggest concern is marketing and profit. With nearly everything else, they go "cheap" -- until a serious issue crops up.