Nursing Home VS. Assisted Living

[quicksoapy]

I am a new DON at a LTCF that needs a lot of work. I think I have bitten off more than I can chew. I believe had I accepted a DON position at an established facility with good systems into place I could be more productive. There is a position open at an assisted living facility near me. My question is how much difference is there in the nursing home vs. assisted?

[twinsmom788]

It depends on what state you are in, but normally there is a HUGE difference in the two. Federal regulations/medicare do not apply in assisted living facilities. In my experience, ALFs normally have only 1 RN as the "director" and employs LPNs to give medications. Some states have "medication aides" to give meds except for the narcotics, but those waters are murky at times.

Are you new to LTC or new as a DON or both?

[quicksoapy]

I am new to both.

[noc4senuf]

For the most part, unless a DON is retiring, there is a "reason" the position is open to begin with. Usually, there are issues in the building to go along with it, whether it is survey related, staffing, etc. I have been traveling and doing interim DON work in facilities that can not find a DON. Each facility has/had issues.

If you decide to stay, start by looking at your staffing. How is the attendance of staff? Is it being monitored and are they held accountable? Then look at your policies and procedures. Are these current? Do they need work? Are they being followed? Does updated training for staff need to take place? Do you have a good management team under you that can be trusted to hold there own? This is not an end-all list, just a place to start.

As for ALF, there is less documentation. The DON in these facilities is more hands on and not in the office as much. ALF is more of a social model, where LTC is more of a medical model. Two different ballgames.

[Havin' A Party!, ASN, RN]

Can be very time-consuming.

Have seen management make huge demands, and typically there are less staff members you'll be able to rely upon.

Staffing / call-offs are often a big prob, and if no one else can cover the med / wound pass, you're it.

Good luck!