Re: Nursing Home Balancing How do we make LTC's understand what Minimum Staffing really means Somehow I think they are confused as well------->>>>>

Posted by Gary Ilminen, RN on July 28, 19100 at 11:42:20:

In Reply to: Nursing Home Balancing How do we make LTC's understand what Minimum Staffing really means Somehow I think they are confused as well------->>>>> posted by Shari on July 28, 19100 at 00:25:33:

:Help making the case for better staffing is available.
Shari, I agree with you--the facility is light on staff, but it is hard to prove it in terms that others can easily understand. Only you and your coworkers know how hard you work every day trying to meet the needs of those in your care. Federal laws currently in effect don't help, either, saying only that the nursing home must have staffing "sufficient to meed the residents' needs." But there are ways to document the need for improved staffing and there are some nationally recognized sources for back-up on the subject. The National Citizens Coalition for Nursing Home Reform (NCCNHR) published a proposal for minimum nursing home staffing back in 1995. In light of recent reports, they are renewing their call for federal mandatory minimum staffing levels in the nation's nursing homes. They call for a staff to resident ratio of 1:5 on day shift, 1:10 on PM shift and 1:15 on nights. You can find the NCCNHR website by going to the Administration on Aging site: http://www.aoa.dhhs.gov/aoa/dir/144.html. Another recent report funded by the Commonwealth fund draws a straight line between malnutrition and dehydration of nursing home residents and short staffing. No CNA should go without reading this authoritative report and being able to quote it when pushing for better staffing. Find it at:
http://www.cmwf.org/programs/elders/burger_mal_386.asp. My book, "Consumer Guide to Long-term Care" discusses several other things that are indicators of insufficient staffing in addition to malnutrition. They include skin breakdown, contractures, inappropriate use of physical restraints and psychoactive drugs. You can get it from Amazon.com, Barnes & Noble stores or their website (bn.com) or ask for it at most book stores. Best of luck, Shari.

: THIS PICTURE IS VERY WRONG.
: This nursing home called me tonight, about their new staffing ratio.
: They claim they are OVER STAFFED. Yes, They have too many working on 2-10
: what is called our Play time shift.
: they gave me the ratio for it today
: 6a-2p shift = 12 residents to one cna
: 2p-10p shift= 15 Res to 1 CNA
: 10p-6a shift = 18 residents to 1 CNA

: APPARENTLY, they are figuring out into this the skilled and NON SKILLED.
: The nursing home has about 80 residents.

: Either way I told them NON SKILLED residents that do for themselves for the
: most part should not even be included in this overall figure.
: It is skilled care that requires the ratio of 6 (at best) to 1 ASSISTANT.
: Somehow. they are confused about HOW TO LUMP UP this staffing ratio and
: with all the paperwork they saw on it, they are still confused.

: They feel that with only 80 residents in the LTC at this time and no one
: coming in that they are having to chop back the CNA Care.

: They balanced the ratio out per 80 residents. Skilled and non skilled (6-2 shift)
: with simple math I suspect. 80 residents per LTC
: A hall 1 assistant = about 10
: B hall 2 assistants = about 10 skilled
: C Hall and D hall combined = 1 assistant = 2 skilled
: F hall 2 assistant (alzheimers dementia unit) and one Activity assistant who
: can act as a CNA if needed
: G hall 1 assistant = 11 skilled

: 1 FLOATER to do A B C D G
: WHAT THEY ARE confused on is how to balance out the ratio if they have
: skilled and non skilled mixes per floor
: I know this sounds confusing as all get out. but It is obvious to me they
: need to do a remix of room stuff. Keep all the sufficient no hardly need
: care on c and d and move any other resident who needs any type of care to the
: other floors.

: WHAT ARE YOUR THOUGHTS??? I'm getting confused just reading all this back to
: myself.

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: :Help making the case for better staffing is available. : Shari, I agree with you--the facility is light on staff, but it is hard to prove it in terms that others can easily understand. Only you and your coworkers know how hard you work every day trying to meet the needs of those in your care. Federal laws currently in effect don't help, either, saying only that the nursing home must have staffing "sufficient to meed the residents' needs." But there are ways to document the need for improved staffing and there are some nationally recognized sources for back-up on the subject. The National Citizens Coalition for Nursing Home Reform (NCCNHR) published a proposal for minimum nursing home staffing back in 1995. In light of recent reports, they are renewing their call for federal mandatory minimum staffing levels in the nation's nursing homes. They call for a staff to resident ratio of 1:5 on day shift, 1:10 on PM shift and 1:15 on nights. You can find the NCCNHR website by going to the Administration on Aging site: http://www.aoa.dhhs.gov/aoa/dir/144.html. Another recent report funded by the Commonwealth fund draws a straight line between malnutrition and dehydration of nursing home residents and short staffing. No CNA should go without reading this authoritative report and being able to quote it when pushing for better staffing. Find it at: : http://www.cmwf.org/programs/elders/burger_mal_386.asp. My book, "Consumer Guide to Long-term Care" discusses several other things that are indicators of insufficient staffing in addition to malnutrition. They include skin breakdown, contractures, inappropriate use of physical restraints and psychoactive drugs. You can get it from Amazon.com, Barnes & Noble stores or their website (bn.com) or ask for it at most book stores. Best of luck, Shari. : : : THIS PICTURE IS VERY WRONG. : : This nursing home called me tonight, about their new staffing ratio. : : They claim they are OVER STAFFED. Yes, They have too many working on 2-10 : : what is called our Play time shift. : : they gave me the ratio for it today : : 6a-2p shift = 12 residents to one cna : : 2p-10p shift= 15 Res to 1 CNA : : 10p-6a shift = 18 residents to 1 CNA : : APPARENTLY, they are figuring out into this the skilled and NON SKILLED. : : The nursing home has about 80 residents. : : Either way I told them NON SKILLED residents that do for themselves for the : : most part should not even be included in this overall figure. : : It is skilled care that requires the ratio of 6 (at best) to 1 ASSISTANT. : : Somehow. they are confused about HOW TO LUMP UP this staffing ratio and : : with all the paperwork they saw on it, they are still confused. : : They feel that with only 80 residents in the LTC at this time and no one : : coming in that they are having to chop back the CNA Care. : : They balanced the ratio out per 80 residents. Skilled and non skilled (6-2 shift) : : with simple math I suspect. 80 residents per LTC : : A hall 1 assistant = about 10 : : B hall 2 assistants = about 10 skilled : : C Hall and D hall combined = 1 assistant = 2 skilled : : F hall 2 assistant (alzheimers dementia unit) and one Activity assistant who : : can act as a CNA if needed : : G hall 1 assistant = 11 skilled : : 1 FLOATER to do A B C D G : : WHAT THEY ARE confused on is how to balance out the ratio if they have : : skilled and non skilled mixes per floor : : I know this sounds confusing as all get out. but It is obvious to me they : : need to do a remix of room stuff. Keep all the sufficient no hardly need : : care on c and d and move any other resident who needs any type of care to the : : other floors. : : WHAT ARE YOUR THOUGHTS??? I'm getting confused just reading all this back to : : myself.

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