Is there a difference between a SNF on hospital grounds vs. free standing SNF

[blessed_RN]

I was wondering if there is any difference in acuity, patient ratio, (RN) skills used, RN responsibilities between a SNF, which is adjacent to a hospital, vs a free-standing SNF, which is not affiliated with any hospital. Will the RN expectations be the same in both facilities, and location really does not have any influence on the internal structure (ie. will I also have MANY multiple patients in a free-standing SNF location compared to something closer to what my state (CA) nurse-patient ratio might be if I was in a SNF connected to the hospital?)

Any insights from anyone who as worked in either type of SNF situations, or someone who interviewed for a SNF connected to a hospital would be appreciated.

Thanks.

[willow1568]

WOW, that is a loaded question. I think it would matter, but not for differences you are asking about. Mostly it matters based on state regulations and finances in regards to SNF.

[LHH1996]

when i worked at a SNF attached to the hospital, it was a much higher acuity. There was no sending patients to the ER for uti, blood, etc etc. When someone coded we did it,when someone needed life flighted we did it, there was a wider age range of patients. Also the doctors often came in more often. ( In longterm care regulation, it is initially and atleast every 30days). If the resident needs a certain procedure it was often done at the bedside if able by the doctor with RN assist, Post -op patients came to us sooner...Later, they did change some things for "cost saving" reasons..like giving blood..but we still could do iv's etc.. (alot goes into how a SNF gets paid what procedures "cost too much" to do onsite..

But anyway..now i work at a free standing SNF and it is much more "boring" in the sense of what i was used to do prior..

as far as staffing..there are regulations to follow. and most SNF's will stick with staffing for acuity when needed otherwise doing just above what is regulated.

[ArwenEvenstar]

when i worked at a SNF attached to the hospital, it was a much higher acuity. There was no sending patients to the ER for uti, blood, etc etc. When someone coded we did it,when someone needed life flighted we did it, there was a wider age range of patients. Also the doctors often came in more often. ( In longterm care regulation, it is initially and atleast every 30days). If the resident needs a certain procedure it was often done at the bedside if able by the doctor with RN assist, Post -op patients came to us sooner...Later, they did change some things for "cost saving" reasons..like giving blood..but we still could do iv's etc.. (alot goes into how a SNF gets paid what procedures "cost too much" to do onsite..

But anyway..now i work at a free standing SNF and it is much more "boring" in the sense of what i was used to do prior..

as far as staffing..there are regulations to follow. and most SNF's will stick with staffing for acuity when needed otherwise doing just above what is regulated.

My experience was the opposite of above. So this may vary from place to place. A hospital I used to work at had an attached SNF. I worked in the hospital as a staff RN, and I worked in the SNF as a clinical instructor with LPN students. The SNF patients were not higher acuity, but typical long-term and stable nursing home residents. If a SNF resident became acutely sick, they were rolled down the long connecting hallway to the hospital ER for treatment, and were admitted to a hospital bed if need be.

Although I do not remember the exact nurse (LPN) to pt staffing ratios at the SNF, they were good and better than your typical nursing home. RN's only did supervisory work, and I never saw any that were directly involved with hands on care.