Patient ratios in nursing homes

jsteine1 · Aug 30, 2005

Hi everyone. I am new to nursing (LPN) I passed my boards in March. I know I have seen discussions about patient ratios, but I have a statement/question: I recently started a job in a nursing home, on the sub-acute floor the ratio is 1:12 (day shift)-is this normal? On the long term care floors, the ratio is 1:36 (day shift). How can this be right???? I'm scared!! And let me tell you the residents on the long term care floors have between 10-15 meds each. I don't know if i can do it! I need to know if this is the norm in New Jersey nursing home facilities. I became a nurse to help people, and now I'm scared I will do more harm than good. Thanks for any responses, I appreciate it!

Are you quoting ratios of licensed staff to patients? Ratios are mandated by ACHA these days and they include the CNAs in their reported numbers, so that brings the ratios "into line" statistically. The subacutes are your Part A patients, in for a relatively short stay, averaging 20 days for rehab or a post op recovery or just an acute episode of any kind. If there are a lot of wounds and treats in addition to meds, this is a tough situation for sure.The long term floors are your Part B/Medicaid patients requiring generally custodial care. Hopefully, you have a good size CNA staff to support these patients needs. Having said that, its scary all right and you can thank PPS for this, just one more regulatory gift to the senior population. Use your rehab department to the hilt.Some PTs do all the wound Care in the SNF setting. Is the therapy 7 days a week, makes a big difference. Most SNFs dont take full advantage of the rehab skills.

Refer patients for seating and positioning, do they offer a dining management program, all patients who are at high risk for falls should be screened for therapy to improve balance and ambulation. Speech should be involved in weight loss , diets and nutrition issues. Behavioral issues, suspected early dementias? Speech therapy again. They are great at cognitive work. The more functional your patients are, the safter those tight ratios become. Good luck and I applaud you for imprioving the lives of seniors through your work in the long term care setting.