Can CNA's dispense meds in NH? Skilled nurse on site?

Specialties Geriatric

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Help. My question is two fold. first, my father is in the Alzheimer's unit of a nursing home. The building he is in is not physically connected to the larger nursing home, (it's walking distance). An RN comes over to the Alzheimer's unit several times a week to fill each patient's pill box. The meds are then dispensed by CNA's. As far as I know these CNA's have no extra med training. The building also does not have an RN or LPN in his building. An RN periodically stops by. Issue #2: we, the family members have requested a skilled nurse to be there at all times, and were told, it can be done, but the money will have come out of our pockets. We are already paying $3,000 a month cash, and they want more. Am I crazy or is there something very wrong going on there?

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Specializes in Vents, Telemetry, Home Care, Home infusion.

If the Alzheimers unit is an assisted living/boarding home facility (surmise it is since seperate from SNF) then no licensed professionals required to be on site 24/7. Since RN prefilling medbox, CNA only assisting resident to take meds.

Only those facilities that are classified under Medicare as skilled nursing facility require a licensed professional on-site 24 hours a day. Regs are so loose, can be one nurse for 200 pts, unless state more restrictive.

State Residential Care and Assisted Living Policy: 2004

http://aspe.hhs.gov/daltcp/reports/04alcom.htm

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Specializes in Education, Acute, Med/Surg, Tele, etc.

My patients and I were fortunate enough to be in an assisted living that had half the building more LTC style...with one nurse 24/7. Although CNA's passed out the medications under the assignment of an RN. They did have training, and were monitored every three months (more if mistakes were seen, and us nurses checked daily...and so did the other CNA's!). But me as a nurse had 140 pts and over 25 CNA's to check per shift! THAT was a lot...and I always felt run down and felt my best couldn't cover anything! It was heartbreaking, and I finally left!

BUT...the basic rent started at 5 thou!!!!! That didn't include nursing or medication services! SO it makes a huge difference in cost. I guess that is why those businesses that make these facilities make money! (believe you me, us Nurses and CNA's didn't see the money at all...borderline brutial insurance if that..they liked to hire us all part time or let us go home early to keep us out of insurance! Other benifits..yeah right..NONE!!!).

The trick is really LOOK before you buy! Take the time to see through assisted living and LTC pretty exteriors and promices. I have said it before and bears repeating...it is akin to a gorgeous cake...sometimes you bite into that wonderful sweet frosting with roses on top...and break your teeth on concrete! Some of these places spend so much money on looks and overstating the services to make it look good..makes sense...they have to sell their product....but in the end...did you get a cake or concrete?

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I was actually a little freaked when the retirement home told me the PSW's do this.Then I saw what training they had.The pharmacy trains them and the head office trains them, the nurse and manager train them.Then they have to be supervised for 6 weeks EVERY time.Then and only then can they do meds.These ladies are what I suppose CNA's are in Canada.They went to school as I did (except I took a 6 month med course) for a least a year or more.The RPN program is only 2 years here.

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Specializes in LTC.

Ask about the training that the CNA's have reguarding medications. Also ask about emergency policies (ie. What happens when my Dad get's sick, what happens if Dad falls, is there a liscensed nurse that the CNA's contact at all hours, in case of emergencies does an LTC nurse come to the unit?).

Before you start to worry to much, find out exactly how things operate within the facility.

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