Question about skilled nursing and g-tubes

[Jolie, BSN]

Is it common for a skilled nursing facility to refuse to accept a resident with a g-tube?

We are searching for a placement for my dad who is expected to be DC'd from the hospital by the end of the week. We do not yet know whether he will require a g-tube, as he has been too heavily sedated to cooperate with a swallow study. One facility we contacted said they would not take him if he has the g-tube, but would if he does not need one. That seemed odd to me, as I would think that g-tubes would be somewhat common in skilled facilities. I am wondering if this is a red flag that they lack knowledgable staff, and perhaps we should cross the facility off the list, even if he does not end up needing the g-tube.

Any opinions?

[muffie, RN]

good luck with your father's convalescing

[michellemybelle]

I think that it's up to the facility. I'm at a MICU and a lot of our patients are either vented, trached, and/or g-tubed. It's my understanding that only SOME nursing faciities accept these patients because the staff needs more training. It wouldn't be a red flag to me, it would just signify the facility's patient population and preference in care.

Hope this helps!

[CapeCodMermaid, RN]

I've worked in 5 different SNF's and we NEVER would refuse an admission simply because the patient had a GTube. It's a basic nursing skill and I can't imagine that would be a reason to say no. Perhaps it is because he isn't cooperative...maybe the hospital worded it in such a way that would make the SNF think your dad is a behavior problem.

Good luck.

[Jolie, BSN]

Thanks for your replies.

My dad can be difficult to manage from a behavior standpoint, so I would understand if the facility refused on that basis. He is known to the staff there. That is why it puzzled me that they stated that they would only take sans the feeding tube, rather than stating outright that they would not accept him. There is a possibility that he won't need the g-tube, so that condition may not exclude him from admission there.

It just seemed odd to me that they would not accept a resident with a feeding tube, which must be fairly common in skilled nursing settings.

[1776patriot]

I've worked in 5 different SNF's and we NEVER would refuse an admission simply because the patient had a GTube. It's a basic nursing skill and I can't imagine that would be a reason to say no. Perhaps it is because he isn't cooperative...maybe the hospital worded it in such a way that would make the SNF think your dad is a behavior problem.

Good luck.

I know some facilities that refuse them because of the greater staffing levels required to care for feeding tube patients. Some facilities strive hard for a 'home' like atmosphere and that might not be a good fit into their population.

A typical LPN in a LT care facility has 15-18 patients each requiring multiple med passes, resp tx, ect. Having one or two tube feeders can make a very tough assignment. It's very time consuming to crush each med, mix with water, give via tube, flush, repeat x times.

Tubes can get pinched off and clog up. CNA's disconnect them to move the patient and it gets clogged because they didn't tell you and give a chance to flush it.

Jolie, I wouldn't take it personally. I'm sure there is a quality place that would be a good fit for your father. Best wishes.

[Nascar nurse, ASN, RN]

In lots of years experience, I have never seen a denial for admission only due to a G-tube either. Seems very basic care.

[suzanne4, RN]

Sounds like there is more to the story, and the facility is not giving it all to you. G-tubes are standard in most SNFs. There may be other reasons that they are refusing.

But I am sure that there are others that would want him, focus on those.

Best of luck to you.

[lovingtheunloved, ASN, RN]

Uh, skilled being the operative term, why would they not? It's a skill any beginning nursing student knows. Residents in nursing homes are a lot sicker than they used to be, and vents, trachs and tubes are not at all uncommon.

[nj1grlcrus]

the nursing home I did clinical in would not take him, my instructor tried to get her father-in-law in there, because its a great place, but NO, so some really good nursing homes don't take g tubes, even though they claim to be skilled, good luck, but don't think its just you

[weesyanne]

Most skilled care facilities will accept a g-tube. They are very common in nursing homes.

My dad had one and we had no problem with his nursing home placement on that basis.

[jjjoy, LPN]

It might be that they already have filled their quota of g-tubes and to add more would demand more nursing care time than they can accomodate.

My short stint at a SNF, the nurses passed meds to up to 30 patients, of which 2-3 had g-tubes which generally did take considerably more time d/t flushing, etc.