Different business models in LTC

[ShelbyaStar]

I'm curious if there's any thoughts on as to whether the business model impacts the quality of care. There's a lot of threads here discussing good vs bad LTC facilities. Do you think it's better to work for a small facility, one owned by a larger corporation, for a non-profit...?

I am a new nurse and I had a couple job offers at different facilities. I chose one that is owned by a larger corporation. I had the thinking that maybe budget wouldn't be as large a problem as it is at non-profits, but it seems that with this model, you have people in an office somewhere saying census is low and therefore one nurse should be able to do it all. So even if there is more budget to go around, there are still cries about it because the profit must be as large as possible.

I am running into a lot of the same problems I hoped to avoid by avoiding a non-profit, and am wondering if I went about it all the wrong way. Understaffing, aides being cut, running out of supplies, etc. On the plus side, I do get paid a couple bucks more per hour than other places offered, and there's some pretty generous retention bonuses. Not sure if it's worth it though, if the grass is indeed greener elsewhere.

Any experience? Does it make a difference? Just wondering if there's something in particular I should shoot for if I do decide to move on, or if it's trial-and-error finding the right facility.

[kummerspeck]

We have a ton of different big/little company LTCs where I live. I have noticed that most of the big ones have bad reputations, while the smaller ones (like the non profit where I work) have much better reputations and hold onto their staff longer. They may pay a bit less, but not always. I did clinicals at one of our big ones and hated the place, felt completely unsafe the whole time I was there. I feel completely safe and supported where I am now.

Good luck!

[taivin]

Definitely smaller. I worked in one where I was charge over a 3 story building with 286 beds skilled and unskilled (yes, only one RN to oversee all that!). Then I worked at a facility that only had 40 beds. Communication, moral; everything much better controlled at a smaller facility. Those are the only 2 LTC places I've worked, and it was like night and day...of course. Then again; it's really all about management. Are they on your back or not? Do they want to hire sheep or leaders...the large ones mostly want sheep IMO.

Most large cities will pay the states going union hourly rate for an RN in LTC; if not more, from my experience. The farther out in the boonies you go, the lower the pay gets for all paths of nursing IMO.

[CapeCodMermaid, RN]

I've worked in tiny -40 bed- places and large -181 bed- places and all sorts in between. For profit and not for profit. It really depends on who owns the building. I worked in a not for profit that cut staff 4 times in 3 weeks and was told the investors wanted a return on their money. Doesn't sound not for profit. So many variables. If you're happy where you are then stay.

[CoffeeRTC, BSN, RN]

I've worked in a small 50 bed facility that was owned by a for profit big chain and then changed to a small not for profit owned facility. I miss the big for profit so bad!!! With a corporation, there are clearly indicated chain of command, policies and procedures ordering practices, manuals.....etc. So so much with the smaller not for profit. There are different consultants for everything.

I've also worked in a few facilities that were around 200 beds. I like my little facility better. We know our residents and families. Staff is tighter knit too.