Long Term Care Cutbacks

mschris · Oct 1, 2011

Not to get too specific to include Company names, but was wondering what the atmosphere is in general about mcr/mcd cuts and what it is doing to long term care. How specifically is your facility effected? Are you seeing staffing cuts, supplies, dept. budgets, or being asked to take a salary cut? Are you seeing a direct effect on patient care?

The facility where I work have changed supplies to a cheaper and less effective brand. They have also increased our lunch break time from 30 minutes per 8 hour shift to 45 minutes per 8 hour shift (when census is below 75%). They are also decreasing the number or aides on the floor from 4 to 3. So, yes, I sincerely believe that patient care will be effected...

montecarlo64, ASN, BSN, LPN · Oct 1, 2011

My facility has made extreme cut-backs in the past few months...Eliminated a whole nurse for a unit, which is now divided between the remaining 2 nurses, who have their own units...CNA assignments are extremely heavy...One assignment has 19 residents and we have very few residents who are self sufficient..Very sad direction that LTC is heading in...

Bella'sMyBaby · Oct 1, 2011

My LTC Corporation has not given me a cost of living raise in 2 years.

Last year, my raise was only 1.5%, this year no raise at all.

My Insurance more than doubles beginning in 2012, therefore I changed plans.

My facility continues to use budgeted MDS hours in the Nursing Dept (Management does not think we know this).

I've not seen a change in patient care; we continue to have high turnover rates, as usual. :rolleyes:

jcox121 · Oct 1, 2011

At my facility, they have cut our sick time from 6 to 3 days, the nurses have to clock out for lunch, we are on a wage freeze, and the staffing has an increased load. Patient care is definately affected. Sometimes I feel I just do not have the time to spend with my residents like I want to. And it is not even the patients, that keep you busy, it's phone calls and therapy and getting new orders and admissions and all the little things that steal your time, and then your 12 hour shift turns into 13-14 and it's frustrating.

DNS on the go · Oct 1, 2011

Medicare cut the reimbursement 11.1% starting with the MDS books that are submitted with an assessment reference date (ARD) of 10-1-11 (today). We were rushing to have as many books done with the ARD of 9-30-11 as possible. Too many cuts are coming to even comtemplate. In NYC most of the facility are for profit and the owners are not going to take any loses...only the employees and the residents. It is sad but the nursing home industry is really just a business. We have numerous consultants in who are helping the owner to reduce costs. I am sure layoffs are coming as is consolidation and other cost saving measures. With the glut of nurses available the issue of staff leaving does not matter (it never really did in the nursing home industry). I am scared as the NH is my extra job but for those who actually make it their main job I offer my sympathy. I will add that things are not great for the other disciplines (PT, OT, pharmacy)...cut backs and a glut of workers will to step in to the few jobs makes this a terrible market. Good luck to all you LTC nurss.

CoffeeRTC, BSN, RN · Oct 1, 2011

Every single minute of OT is scrutinized. (it should be, but the big offenders should have been dealt with long ago) Our supplies are already at a minimum. The must punch out for lunch thing is getting a big push..even for the staff that have been grandfathered in and have been there for more than 10+ yrs (we are now loosing that 1/2 hr per day out of our pay). Admission inquiries almost always get a "yes" no matter what the current or PMHx is. .....the list can go on.

Yes...its a business, but this is from the government.

Forever Sunshine, ASN, RN · Oct 1, 2011

Every single minute of OT is scrutinized. (it should be, but the big offenders should have been dealt with long ago) Our supplies are already at a minimum. The must punch out for lunch thing is getting a big push..even for the staff that have been grandfathered in and have been there for more than 10+ yrs (we are now loosing that 1/2 hr per day out of our pay). Admission inquiries almost always get a "yes" no matter what the current or PMHx is. .....the list can go on.
Yes...its a business, but this is from the government.

Thats basically how our admissions have been lately and its not a good thing for anyone involved. Staffing is up by a smudgen because the state will be dropping in soon. Then its going to go back to bare bones. Resident care suffers.

They haven't complained to me about overtime. My response , "Well get an admissions nurse for all the admissions you keep sending in."

NotFlo · Oct 2, 2011

It started with multiple layoffs. None to the nurses or CNAs, but in many ancillary departments. Then they did cut two 40 hr. nursing positions (but people who didn't work directly on the floor, but supported the floor staff, so now we have to incorporate their jobs into ours every day, which is proving impossible).

Supplies are scarce and cheaper than ever, they are taking any and all admissions which has resulted in our subacute units resembling long term dementia wings with very frequent falls and skin issues without the proper staff to care for these people. Also taking complicated wounds and dressings without wanting to pay for the supplies to properly care for these people. Esp. bariatrics...more back injuries for the staff than ever but they wont get the proper equipment and staff numbers to care for these people safely.

PT/OT is crazy with the changes. They were always "minute" focused, now they are over the edge. They don't get paid for "waiting" for the patient and a whole host of other things so they don't care if the pt. is ready or not, has their pills or not they are hurtling them toward the gym or making the CNAs do it (because they can't charge minutes for transporting the pt. either apparently).

Our health insurance plan is a total joke and totally unaffordable.

To top it all off we were just informed that everyone is getting their pay cut by 3 percent. The raises are so paltry to non-existant that I'm now making less than when I started a number of years ago.

I don't know what's going to happen. It's bad. Patient care suffers, as always.

CapeCodMermaid, RN · Oct 4, 2011

We all need to become more politically active. The government seems to have enough money for some questionable things. There should be enough to care for people who have worked and paid taxes their whole lives.

katoline · Oct 4, 2011

I came across this before i left for work this am. Oh ug! What next?

WASHINGTON - As the deficit reduction supercommittee hunts for $1.5 trillion in additional savings, US hospital executives are so worried about having their payments cut that they plan to start lobbying Congress next week to shift the burden onto their elderly patients - specifically by raising the age of eligibility for Medicare.

The American Hospital Association is rallying hundreds of hospital leaders to descend upon the Capitol on Tuesday and urge legislators to consider increasing the Medicare eligibility age from 65 to 67 as one way to save money without reducing payments to hospitals. That move is so controversial that President Obama, who once expressed a willingness to entertain the change in Medicare age eligibility, omitted it from his deficit-reduction proposal last week.

katoline · Oct 4, 2011

:saint:Oh NotFlo, I'm sorry to say, i believe you may work for the same company i do. too many similarities. Love the people i work with and the residents, but i have to wonder when is the line drawn where some top execs have to say to shareholders, we are in the people business and these people are our parents, grandparents and neighbors. maybe they truely don't know what it is like on the front line and need to come on down. until things effect us personally, it's sometimes hard to relate. we've all got to answer to someone in the end, i just hope i'm able to pass thru the gate.