how can our LTC save money???

TheCommuter, BSN, RN · Feb 27, 2014

Instead of staffing with 2 nurses for 40 residents, staff with 1 nurse and 1 medication aide / medication tech. Since medication aides are paid significantly less than licensed nurses, this results in less money spent on wages.

amoLucia · Feb 27, 2014

Wasting of supplies is a big loss. Is there some way to slow down wasted items? I bet if you go into your shower room, you'll find several shave crèmes, shampoos, etc just left in there. You can't give them away now - wasted! Is your supply room locked?

It's not just CNA stuff that gets wasted. I've seen extra foleys, pistons, enteral equip, incl supplements left in rooms as overflow. Wasted!

LPNMary · Feb 27, 2014

Why does a 40 bed place have an ADON? Seems those LTC places are always trying to save money on cheap stuff like housekeeping while they ignore the elephant in the room.

DHawkinsrn · Feb 27, 2014

Why does a 40 bed place have an ADON? Seems those LTC places are always trying to save money on cheap stuff like housekeeping while they ignore the elephant in the room.

So true!

CoffeeRTC, BSN, RN · Feb 27, 2014

What is your OT like? What about staff turn over?

motherof3sons · Feb 27, 2014

I agree with the one RN and one med aide. Also agree with the one DON....I don't see the need for an ADON. For our 42 residents, we have 5 CNA's on evenings, 4 on nights and 6 on days.

txredheadnurse, BSN, RN · Feb 28, 2014

Probably have the ADON because otherwise the DON is on call constantly without a break. Plus there are many things that fall onto the DONs lap that floor nurses may be unaware of being her/his responsibility. Having two admin nurses is not a waste of money.

I would also suggest looking at all the meds, especially the OTCs and PRNs and discontinue those which haven't been used in more than 60 days (PRNs) and look to reduce the OTCs and nutritional supplements. I found during my audit days an average of 5 nutritional supplements and 4-5 OTC meds being given routinely. Have the Medical Director draw up a list of comparable meds to be substituted for those expensive drugs the hospital always seems to order (such as protonix for GERD) so as to reduce costs. Few folks really require protonix routinely but it quite pricey compared to prilosec or zantac or pepcid. The dietician can be a good resource for reviewing the nutritional supplements such as vitamins. Does someone really need prenatal vitamins plus ocuvite plus a b complex and folic acid and vitamin B12 and vitamin C? Having up to 5-6 different formulations of calcium and calcium plus D also gets to be pricey.

Mandychelle79, ASN, RN · Feb 28, 2014

Have the adon on the floor unless the don is on vacation

CoffeeRTC, BSN, RN · Feb 28, 2014

Look into your wound care supplies. Are they being wasted? Can you go to daily or q o d changes?

CapeCodMermaid, RN · Feb 28, 2014

An ADON for a 40 bed facility? Not needed. Wound supplies...my former facility used to spend thousands on fancy creams because the supplier told them they were needed. They were spending 25-30 dollars for one tube of cream. I switched to A&D ointment which was about 80 cents a tube...skin was great! Check the usage of briefs. Some aides use large ones on everyone thinking they are more absorbent..they're not. Not all states allow medication techs. Massachusetts is one of them so we can't save there. Make your own milkshakes instead of buying premade supplements. They taste better, are nutritionally similar and can save hundreds of dollars.