Choosing a LTC/SNF to work at as a new nurse

Specialties Geriatric

Published

Hello All,

I'm a new grad RN who has been unsuccessful in getting a hospital job. I'm now beginning my search for jobs in nursing homes, even though LTC is not where I'd like to start. After hearing so many horror stories about the problems in these facilities due to staffing issues, poor management, etc., I'm really scared about getting myself into a bad situation.

So far, my strategy is getting a list of all the LTC facilities in my area and comparing them on websites like Medicare.gov and CalQualityCare.gov (I'm in California). How much can the government ratings be trusted? Should I only apply to those facilities with average or above average ratings?

There's a beautifully-renovated nursing home close to my house, and it smells and looks very clean the times I've been there. BUT, it has a 1-star rating!! :( And supposedly a 94% nursing staff turnover, while the state average is 57%. Should I stay far, far away from facilities like this??

Thank you so much for any and all advice you can send my way!

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Specializes in Critical Care/Coronary Care Unit,.

You sound like you have good plan...so I think you answered your own question. Also try the following sites to compare Snfs. Hospital Compare - Compare Care Quality | HealthCare.gov

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My wife and I have had very similar experiences with LTC/SNFs compared to their ratings. They are not 100% on BUT the lower the rating generally mirrors the working conditions.

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Specializes in Professional Development Specialist.

My facility has 2 stars overall, but 4 out of 5 stars for nursing staff. But I can tell you that we have significantly higher nurse/patient ratios than the 5 star facilities. Looking at facilities in my area, some have great reps with 2 stars and others have horrible reps with 4. I wouldn't focus so much on the rating but instead go with your gut and overall experience. In my experience a job for a new nurse even in LTC isn't so much your choice as the employers. I was grateful for the offer and 6 months later still surprisingly happy most of the time. There are stressful days, and stressful patients, but overall I'm still happy to go to work every day!

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Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

Lower ratings mean that they did not do well on their surveys and that they may have staffing issues. Be careful with the lower ratings...however, go visit and interview at places and you will be able to tell and "feel" if it is right or not. Sometimes the 5 star system can be misleading in certain instances. Staffing can pull the rating system down as well as the Quality indicators. Now with the MDS 3.0 I am not sure how the rating system will work for the QI's/QM's because there won't be any for awhile. Also the staffing can be a problem because some facilities have learned how to "pad" their staffing hours and increase their ratings. Also there are some facilities that I have surveyed that when I see their ratings, I am not sure why they scored low.

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Specializes in LTC.

I just read up on my facility on that website. I wouldn't give them a 4/5 for staffing. lol I'd give them a -2.

You can use this as a guide but don't make your decision unless you actually see the facility and are given a tour. Pay close attention to the residents, the smell and the staff working.. do they look happy?

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OP, if you look a little further you will find all documents as well as court testimony! If action was taken.

I also had not intended to do LTC. But am also "there" at this point in my job hunt. You will find many experienced RNs are going LTC simply because they want out of the hospital unit they are on, or want off nights and can't find other work either. Newer grads who started LTC, and now want out cannot find hospital openings so they are stuck. Basically things are not turning over as they should. It's a big stalemate. I am heavily considering LTC Hospice case management too.

I would like to do things in the order one is supposed to, but it just is not in the stars. Everybody used to advise me to hold out as long as finances allowed for that hospital opening for a new grad. Now with the worsening economy they say to get any experience you can, and that you cannot hold out for hospital forever.

I just hope ALL YOU NURSE MANAGERS out there know this and will give us a chance when the economy turns around if we still want desperately to work for you and your hospital units.

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Specializes in Gerontology, Med surg, Home Health.

2ndwind-this is the LTC forum so hospital people probably won't see it.

The only way to really assess a facility is to go there and see for yourself. The 5 Star system...flawed. For the staffing category it's about how many RNs there are...not the staff to patient ratio.

GO to the facility. Take a tour....look at the residents. Do they look clean? Does the place smell? (I once turned a job down because the whole building smelled of urine.) Is the staff friendly and attentive? These mean more than some government rating.

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Thanks Mermaid,

I have visited plenty of LTC facilities in my area... I am older, so have friends of family who are in and out of rehab, etc. Have had grandparents, and now parent's friends that are long term. Being so close to it on a personal level is a little disconcerting. Also knowing that my parents might soon need to move... this is why I hesitate. I do like to check on litigation and what the specific violations are for the underperforming facilities. In my state this info is relatively easy to find. I can actually read testimony - which is enlightening to say the least.

I know this is the LTC forum. I read posts from all forums (many do). I don't want to be an island, and be one of those nurses who has no idea about what other nurses do, and what it's like to be them. :heartbeat

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Thank you all for your input. While I'm hesitant to apply for work at a 1 or 2 star facility, I'll tour them just to be sure I'm not limiting my options unnecessarily.

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Thank you all for your input. While I'm hesitant to apply for work at a 1 or 2 star facility, I'll tour them just to be sure I'm not limiting my options unnecessarily.

On a good note the crappier places in my experience tend to pay more...because they can't keep staff otherwise.

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I would absolutely go check them out. Smells, a dirty facility, miserable people. all big warning signs. When I interviewed at my current job, I pulled into the parking lot and thought to myself...what a dump! The building was very dated on the outside. I needed a job,so I went in. Sooo not what I expected. Inside was clean, smelled like apple pie...I am not kidding...The kitchen is right off the main room. It was homey, everyone was welcoming. The CNA's were very engaging with the residents.

So, go check a bunch out. You may get a great feeling from one, and I am sure you will go into some that your gut is going to say "RUN"

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