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What to do if your facility is not following the resident to cna ratio set by law

cnawoman cnawoman (New) New

I work first shift at a long term care facilty in Michigan. Our facility has had low census so they have started to send cnas home early. So on my hall we are working 12 to 1 the law states it should be 8 to 1 and now they are talking about making it one less cna every day that would make it 14 to 1. I give the best care possible but with ratios like that its overwhelming what should i do?

Do you have a union? if so, contact them for instruction, you may need to file an unsafe working conditions report.


Specializes in LTC.

Am not sure if Michigan has an actual law regarding CNA:pt staffing ratios. Might just be a generally accepted practice that your place has followed forever and this would be at their discretion to increase or decrease as they chose.

You could check with you MI state DOH to see what their regulations are and then proceed.

Gooselady, BSN, RN

Has 23 years experience.

I think California is the only state that actually abides by a state-determined caregiver to patient ratio. All the rest of us have state-determined ratios but there's no enforcement, it is decided by the union and other patient safety indicators. So the state law can be 8:1, but there is no enforcement.

In LTC there's even less determination based on 'data'. The ratio can be determined by the owner based on his bottom line (money).

The only thing you can do as an individual is choose where to work. I've heard LTC is routinely understaffed, with overwhelmed CNAs and nurses busting their butts. That seems to be the nature of the LTC beast :( . As a nurse, you have your integrity and your license to guide your decisions on how they will be used. You may not have any way to change or protest what your facility is doing, but you can work somewhere else. Sometimes that's the only choice we can make :)

I guess they count the nurses and cnas together so state seid we can have up to 16 residents per one cna :eek:


Specializes in LTC.

I guess they count the nurses and cnas together so state seid we can have up to 16 residents per one cna :eek:
To be honest,IT IS something like that, really.

Staffing is bare-bones, but administration usually tries to meet the minimum requirements because it's an easy deficiency to figure out and cite the facility.

If you truly believe your place to be below staffing, you can contact the State DOH to voice your concern