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Which SNF to work for??


So here is my situation:

I applied to two positions, and had interviews for both yesterday. We'll just call them Job A and Job B. Job A has great Medicare reviews (5 starts), while Job B doesn't (1 star), which is why at FIRST I thought I would prefer Job A. BUT after going to the interviews, I actually like job B better. The facility is nicer/newer, there are only 1-2 patients/room, the staff bring their dogs to work, and each unit has 2 nurses and 4 CNA's for about 45 patients. (So only about 22-23 pts/RN) They also start at $28/hr, with a $1500 sign on bonus. There would only be a 3-4 day orientation. OH and it is also 1/2 post-acute rehab so there would be lot more variety and short-term patients which would allow me to do more skills than just LTC.

Job A has one RN per unit, which is 37 residents, with 3 CNA's. It is an older facility, and there are 3-4 patients per room. During the interview the only question she asked me was "how do you handle stress?" The rest of the time she just asked if I had any questions. She did say the staff all got along great, and there was very low staff turnover for both CNA's and RN's. She would give me a 10-12 day orientation. The starting rate their is $26.20/hr.

My dilemma is.. I just got offered a job at Job A. I told her I was still waiting to hear back from another facility I interviewed for. She sounded kind of disappointed, and said she wanted to start training someone ASAP (like tomorrow) so that they would be ready by Feb 1st. Job B said they would get back to me by Monday, but I called today and left a message with the DON and asked if they could give me an answer sooner because of my job offer at the other place. Still waiting to hear back from her.. What do I do?? If job B doesn't get back to me by today or tomorrow, the Job A might go with someone else, and I don't want to lose the job offer, but what if I don't even get offered a position with Job B? Is it okay to ask job A for a higher hourly rate?

I've never worked in a SNF before, and have only worked as an RN for 2.5 months in a non-hospital job, so I don't know how to compare quality of SNF's... Thanks for your help!


Specializes in retired LTC.

First word of caution - You're juggling two prospective employers who both know that you're considering strong options at another place. Dangerous because they'll question your sincerity (and subsequent loyalty) in selecting their facility as your first choice of interest. Very risky to expose your cards on the table as you have.

Second word of caution - Be careful not to judge a book by its cover!!! Pretty decor, fancy schmancy benefits, and other self-described, seemingly glowing information may not be all that wonderful. There's real significant reasons for poor survey results and the difference between the two places (5 stars vs 1 star) is very significant.

I've worked both ends of the spectrum. One facility looked like the Taj Mahal from the highway of an up-scaled zip-code community, rooms were gorgeous, but SUPPOSED staffing always ran short, census ran iffy... AND they were in my local newspaper as the WORST surveyed facility in the State.

On the other end, I worked one place where the DON held on to applications because staff openings were so infrequent. Pts included family members of several dept heads and direct MD referrals. We had private pay residents. Some of the equip was not up-to-date most current, new fangled but more old-reliable type; but we always had what we needed for the appropriate level of care. And most of all, our surveys were very, very good.

Thanks for your reply! I think the patient ratio of the place I was offered a job scares me.. 37 patients, versus 23. But hey, low staff turn-over does say a lot about the place. Why would people stay in a crappy facility? Ugh I just didn't know what to say when I was offered the job since I was still waiting on the other one. I've never been put in that position before! Would it be okay to call back and say that I will take the job if they are able to up the hourly rate a little? Maybe $27/hr? Or is that a bad idea? I do still prefer the other job, even though as you say, it may look nice from the outside but not be great at all.. but I dont want to risk losing one job because of waiting on another one that I am not even guaranteed to get! I think I'm going to just wait until tomorrow and if I still haven't heard from the 2nd job, I'll accept the offer from the 1st.


Specializes in Clinical Documentation Specialist, LTC.

I would take a 5 star facility over a 1 star any day. I have a LOT of experience in both little old country homes and homes that could compete with the Taj-Mahal in looks and decor. Guess which ones were the best? ;)

Yes, take the 5 star facility. No, do not ask them to give you a higher rate of pay.

Be wary of places that offer alot of money, bonuses, etc. and promise excellent staffing and orientation periods. There's a reason why they're one star! It sounds like a "bait and switch" game to me. If it were me, I'd go with the 5 star facility every time. Why? Because obviously their clinical outcomes are good, they are recognized as excellent caregivers, and isn't that what its all about? You can be the prettiest building in the world and still give lousy care-and it shows in your performance appraisals, state surveys, and nursing home compare scores. Take job A, you have a whole career ahead of you to be making "big money!"

I did get offered a position for the other facility, but I chose the 5 star one, and am SO glad I did! From the moment I accepted the offer, everyone has been so welcoming and nice. The DON seemed super excited when I called back accepted the offer. A short while later I got a call from the Administrator welcoming me to the facility and saying that the DON was the nicest lady ever, and I was lucky to have her as my manager. Everyone I've been introduced to seems very friendly, and I've heard lots of comments from family members thanking staff for taking such good care of their family. And it was only my 2nd day today! I'm still nervous to have so many patients, but I feel like I will get really good training and have lots of support once I am on my own. :)


Specializes in Pediatric Private Duty; Camp Nursing. Has 6 years experience.

By any chance, was the 5 star facility a non-profit? I worked in a national chain that was be-yoo-ti-ful inside and out. Awful, awful place. I had done clinicals in a county'owned non-profit home and when you stepped inside, it felt and looked like the 1960's. However they get great ratings, since all their money is dumped back into the place and the staff, not in shareholder's and CEO's pockets.

No, it is for-profit, and there are multiple locations around California.