LTC: The good, bad and the ugly places!!!WOW!!

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Specializes in Geriatrics/Family Practice.

I've been working at this one LTC facility. It's not the worst around, but as I found out a recent interview at a different facility there are some beautiful, well staffed facilities. As soon as you walk in it has marble walls and floors. They have a buffet for meals, non-skid hard wood floors in each room, fresh flowers on each dinner table, a Wii for the ambulatory residents, a computer room for the computer literate residents, a bath aide, computer charting, low patient/nurse/CNA ratio, a beautiful rehab room and a unit coordinator, and the list goes on and on. My present facility has none of the above. I'm looking for another job, because I'm in fear of losing my license due to poor staffing and extremely high coorporate greed. The new place is non for profit and my present is. Why is there such a difference in everything? I have my second interview on Monday which is actually flattering considering the other two places I've worked, hired me on the spot. That should of been my first sign of them being very short staffed. I actually thanked them for not hiring me that day. I will miss my residents at my present job, I adore each and everyone of them, but I won't do any good for them if I lose my license. I've complained and went to upper management for the last four months since I've been there and of course gotten no where. I atleast feel I'm leaving knowing I gave it my all and did whatever I could to fight for change, but profit is there highest priority and their residents are just along for the ride. Well thanks for reading and any input regarding the differences in facilities would be appreciated. I still am in AWE of how beautiful and well staffed this new place is and also no urine or feces smell, WOW. And a shower aide, my residents at my present place don't even get showers because of short staffing and it's okay with upper mgmt, because we are short staffed. Talk about making you feel like your giving pi$$ poor care. Oh well that's enough for now.

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Specializes in Med/Surge, Psych, LTC, Home Health.

Well good luck, I hope you get this new job! Sounds like a great place. If I could find a LTC place like that around where I live, I would actually consider working there. =)

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Specializes in Trauma, ICU, CCU.

Hi there! I totally agree with you! I've been a CNA for 9 years, and have only ever worked in hospitals...I've heard some of the "I"m gonna loose my license" fears from my twin sister who is a CNA in LTC. The way that she figured out pretty fast, was that you can usually tell teh SECOND you walk through the door, and for her, around here at least, some of the LTC facilities that are operated by "Lutheran Social Services" or the local "Diocese" seem to be the best. She's worked in 4 total LTC facilities, the last two have been Lutheran Social Services owned...and she LOVES them. They also have time to help their residents shower, a big sunny atrium, lots of activies, great management, computer lab, etc. So I would definitely say that with some LTC facilities you CAN judge a book by it's cover. So you might want to check out your religously affiliated care centers...at least here in Rockford they are VERY nice.

Good luck!

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There really are good/ great places out there. Don't be fooled by how great a place looks and what all they have. Yes...it does mean something, but I also look at the staff. Have they been around longer than a few weeks? months? year? Do they seem happy? Does it seem like they work as a team? or welcome you? Do they actually interview you and look into your references?

I worked at an absolutly beautiful place...great food, nice furnishings, smelled great and even had a facility pet BUT.......

management was all newer, the staff was unfriendly, never had any supplies, poor assessment systems............I ended up going back to my "older" less pretty faclity where staff was always friendy, the meals weren't gormet (sp) assessments were done, pts were cared for.....

Good luck! Hope you get that job!1

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i had second job at a very nice, bigger, affiliated with the one of the best hospital in the country. i thought because this facility is bigger corporation and since they are affiliated with hospital i thought this facility is not going to have any issues, i thought its going to be a better working condition. not so. this facility has more issues than a small facility. they are so uptight about money that they will lock up supply room and aides have to wait for supervisor to take briefs out from supply room and distribute few briefs at a time to each aides. one day each aides are allowed one brief per patient!!! sometimes nurses have to work with no glucometer strips, no supplies to do treatments, etc... they are very uptight about pay too.. they recently changed from no sick day to 4 sick days per year, you cant take vacation on your weekend to work, if you call in during holiday period, you lose your holiday pay ect... the list goes on and on. the managements are so manipulative to the staff , putting so much restrictions on what you can do and cant do. so i wouldnt be impressed by how beautiful the facility is....

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Specializes in Medsurg/ICU, Mental Health, Home Health.
you cant take vacation on your weekend to work, if you call in during holiday period, you lose your holiday pay ect... [\quote]

i don't understand why this is a problem...your weekend and holiday commitments are just that! i've always had to switch with someone to get a weekend off that was my scheduled weekend, and i don't see why anyone should get holiday pay for not working...the premium is for the inconvenience of working, not being scheduled.

jess

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Specializes in ICU, CCU,Wound Care,LTC, Hospice, MDS.

I'm just wondering the difference in the cost to the resident in these very different facilities!

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Specializes in Geriatrics/Family Practice.

My present facility is Medicare/Medicaid and the well staffed one is Medicare/Self pay. There is definitely a difference in environment, staffing and quality of care. It just goes to show you that money talks and of course gets you the best of everything, while the poor to middle class get treated badly.

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Specializes in MS, LTC, Post Op.

I just left a facility that caters to the "rich set". Very nice, clean, staffed well. I liked it, but I became bored. I just started at a facility where my best friend is DON and she needs good nurses who actually know how to be nurses...she asked me to come aboard as a day shift float and I took it.

The residents at my previous facility pay $6,000-$8,000 a month to live there...

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Specializes in Sub Acute LTC Hospice.

Don't be fooled my friend by the looks and modern equipment. It all boils down to the staff. I work in the oldest facility in the state, or almost the oldest. To walk in you would think its a step back in time. *new one is currently under construction btw. anyway i did one year of agency nursing at LTC facilities and some where beautiful, almost gives you chills walking into a new place with walls in the lobby are huge salt water aquariums etc.... Looks can be deceiving. I am the new kid on the block so to speak. on my 3-11 shift i work with three other nurses they have work there for 33 yrs, 16 yrs 11 yrs and then me 1 year. We have scored 2nd highest in the state inspections with no violations. We are smaller than most. 120 beds. 100 LTC and the other Sub Acute and now hospice. Ya everything is old, beds, furniture etc. but it is the care we give. Final rounds are done with two nurses and one CNA half hour before shift ends, everyone is checked to make sure they are clean, safe, we make sure they had a pm snack of their choice, some even have a beer or glass of wine. Our kitchen will make meals to order everything from scratch. Its like being at grandmas house in a literal sense. The facility I work at is one I would look forward to going to if I was ever to have that need. God forbid. Don't get me wrong things are changing fast if you read other posts of mine you will see that the new Sub Acute patients are arriving daily and are more complicated each day. And its stressing. however we were told that we will have 4 nurses and 1 supervisor for 60 patients. Starting next week. So I worry when we open up the new facility that everything will change. We have a waiting list to get in. I can tell you when families first come in and see our place they all say its like a step back in time. Its all about the care. Even our CNAs have been around along time. Several over 20 years that says allot. They are installing plasma TVs in sub acute. They are meant for the new building but its taking longer than expected. Anyway look at your states web site and see the complaints and the scores. When I was an agency nurse and worked in some of the newer facilities half the nurses were imported from other countries and the other half were agency. no continuity in care it was awful. These were the ones that are corporate owned. Don't get me wrong there are allot of good new ones out there esp. the ones who do not take medicaid or Medicare. Fully private ones are always the best of course. We are currently at 50 per cent private pay and that number is dropping fast. Sorry this was such a long post. Bottom line do your research before you start working at a new facility. :wink2:

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Well, my current facility is a not-for-profit and they have all the issues of what Medicare pays vs. what it actually costs to care for these very frail folks.

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Specializes in Gerontology, Med surg, Home Health.

Interesting post. You can make money with Medicare patients if you have a good MDS nurse and good rehab manager who know how to pick the best ARD date. Medicaid is another story, but if you watch the documentation all the time at least you get what you should be getting from the state to care for people. In this day and age, at least in this state, there are very few places who do not accept Medicare. The only ones around here are classified as rest homes and don't have rehab or subacute patients.

As far as the original poster's comments--every facility I've worked in has had the same rule about holidays. If you call out your scheduled shift before or after the holiday, you won't get holiday pay. And about the briefs-we all have a budget to live by. When I first got to my facility, the CNAs were using 8-10 briefs/resident/day. Were they changing people that frequently? Nope...they were hiding the briefs for reasons known only to them. Now since they know we always have all the supplies we need, they have stopped hiding briefs and really only need 3-4 per day.

And finally--it's not really about how the place looks. The most beautiful place around here was almost shut down for not reporting abuse. It seems the administrator paid more attention to the decor than she did the residents.

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