i realize this was not addressed to me but as a don in a very busy snf i felt compelled to answer anyway :) first of all you need to realize that the mcr and mcd cuts that you mention were very significant and in order for many facilities to be able to stay in business they have had to make pretty significant cuts in their budgets. think of it like your own home....if you are used to having an income of 4,000 dollars a month and something happens and now you are only receiving 2,000 dollars a month, i'm assuming you would have to make some financial changes to your budget. that is what is happening in ltc right now.
secondly, you also need to realize that for profit nursing homes are a business. as with any business if you do not have good profits you cannot produce a good product. the same is true in snf's....in order to be able to pay for high quality staff, equipment, etc....you have to have a profit. i'm pretty sure that the nurses that work in my facility like to get paid every 2 weeks and would be upset if we didn't make enough of a profit to make payroll...
lastly the way you feel about ltc/snf's and their management why would you want to become a don? it sounds like you may enjoy another specialty more. ltc is definitely not for everyone.
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