Skilled Healthcare found liable for improper staffing of nursing homes, but the fight is far from over

What was the staffing level at the facilities in question?, and what was the acuity of the residents?
Did they go strictly by numbers?

I do understand a budget, however, believe MOST nursing facilities are grossly understaffed. Especially when you consider the acuity levels; we have many acute care Res that 5 years ago would have still been in the hospital – they are sick & need a lot of attention. When you think of all that needs to be done to care for just one injured or elderly person, it’s mind boggling. Multiply that by 15 or 20 Res (or more if REALLY staff challanged) per STNA – that’s impossible! Then times that by 12 hr shifts – how much patience do you think those staff members have entering the Res’ room? To try to provide each with all the care they require/deserve, (never mind the little things that mean so much e.g. gentle touch, unhurried personal care, etc) you have to know all too often it just doesn’t happen. The elderly move slower, we shouldn’t rush them; they need time to “sit a spell”; many tire easily & need to lay down between meals & to freshened up before the next meal; they need oral care, nail care, to be walked, toileted q2-3hr – requiring incont care several times a day (often OUR fault because we simply couldn’t get to them soon enough…so SAD!) Do the math: the time it takes to help just one, times that number of Res, divided by the minutes per day – it simply doesn’t add up; call lights are on way too long before staff can respond, then Lord knows what you’ll find when you get there because they have waited so long & tried to do it, whatever it was, themselves – very unsafe, yet understandable from the Res’ viewpoint. I honestly believe an assignment of anything > 10 Res is too much (preferabley no more than 8-9), but by today’s standards, that’s nothing. I don’t know how the powers that be find 15 (or >) Res per assignment is an acceptable number – betcha if it was their loved one laying there waiting for care to arrive it wouldn’t even be close to being OK.

It’s not about numbers, it’s about acuity. There are many Nsg facilities with long term care residents that have chronic issues. But as another person wrote, the SNF’s are not what they used to be. We are “observation units”, we are “mini” hospitals. Acute care facilities are transferring patients (not residents) to us critically ill. We are shipping patients back before they get off the gurney. This is about the insurance industry. Let’s see, you’re a total knee? that would be 2 days, CVA 4 days, etc. etc. When is the government going to crack down on this?? Probably never due to special interests; it’s ALL about the money. WE need to make the government accountable to dictate to the insurance industry, not the other way around!

I have worked longterm care since 1995 and have seen a big change in the population of LTC. Much more behavior issues due to dementia, which takes more staff time. More critical care, more care to the residents in general. Many are incontinent and don”t have to be because we don”t have the time to get to them. We at least need more CNA”s. The paperwork is a continuois growing mountain. You need more time to do the paperwork, then there is the med pass. These poor people are on everything under the sun. So the med pass takes a few hours.I think the industry needs to take a realistic look at just what really is having to be acomplished, and who is needed to do the work, and the hands on care to the residents. After all, they are why we are here, for them, not the paper work. What did happen to the actual care of the residents.