LTC

Do Staffing Minimums work in LTC

As a family member, you may but are likely not aware that the Federal Government has recently passed new federal rules that dictate and mandate minimum staffing in skilled nursing home.

Here is a link to the announcement: https://www.cms.gov/newsroom/fact-sheets/medicare-and-medicaid-programs-minimum-staffing-standards-long-term-care-facilities-and-medicaid-0

The real questions facing you is: So What? Does it matter? Does it help? Will this help me and my loved one? I will attempt to answer the above questions and give a little free advise on how best to navigate the constant changing system and rules of LTC from a families perspective.

  • SO WHAT? Does it matter?

    Collectively as a nation it does matter. Some states already has minimum staffing levels that MANY are already not meeting. Many facilities struggle to recruit staff for lots of reasons from location to pay to desired population… i mean, if you want to provide nursing care to infants and mothers… LTC is not going to be a fit for you! Many facilities are highly successful but not at the current state mandated guidelines. I, myself was the administrator to a 5 star building that was deficiency free… but still not meeting the state guidelines. SO… from a families perspective, does staffing matter? The answer is no!

    Let me explain. The biggest predictor of quality of care of an INDIVIDUAL resident is the frequency of visits from the family. I would rather have a family visit 4 times a day for 15 minutes than 1 visit for an hour. It’s about frequency and routine. Example: If I am a caregiver and I have 9 residents that I need to get up. Ms. Jone’s family comes every day at 9 AM and Mr. Smith’s family rarely comes. I am here because I love my residents and I don’t want to disappoint or upset my families… so… guess who is going to be up, dressed and ready by 9 AM every day? I will get to and take care of Mr. Smith… but he will not be a priority in my sequencing of care.

  • Does it help? Will this help me and my loved ones?

  • Volume of staff or high staff to resident ratio’s are not a predictor of quality of care. You can have one care giver to one elder…. and if the caregiver is not engaged and interested…. you will still not have quality of care. Again, the best predictor of quality of care on an individual basis is frequency of family visiting and the families kind, compassionate engagement with the staff. Kindness and engagement go a long way in building the relationship between families and caregivers. The Regulators love this regulation because regulators/inspectors are able to use basic math and when has math been successful in measuring the value of human lives: both resident and care giver.

    This is a link to the AHCA/NCAL evaluation and response: https://www.ahcancal.org/Data-and-Research/Pages/Staffing-Mandate-Analysis.aspx

If you are struggling with achieving the care results that you desire for you loved one… consider giving me call and letting me assist you. I can walk beside you as an experience mentor and coach. I will help you to achieve your results. There is no need to walk alone.

Grace and Peace,

Bryan

Covid and LTC Tips

I like a good roller coaster as much as the next guy and most of us can remember that visceral sensation of thrill and fear combined as the clicking of the coaster on the track started our thrilling ride! In fact, researchers on the subject say that there is “clear evidence that people enjoy the sensations that accompany the fight or flight response within a non-threatening environment.” But the key words here are, however, the words “NON_THREATENING”.

When Covid began to spread from country to country, from one state to the next into our communities, homes and medical facilities, real fear began to rise. This deadly virus demanded response - and both fight and flight were brought to bear in both organized and governmental response and in our personal responses to what was clearly a growing crisis. What followed has been a roller coaster ride - but not one of the good ones!

Covid has made Long Term Care an ever changing and unpredictable roller coaster. Nursing homes are working to meet guidance that can change daily based upon which regulator decides to update guidelines and when. There have been times in the past year that the Centers for Medicaid and Medicare Services (CMS) and the Centers for Disease Control (CDC) have issued conflicting guidelines for care provision… and nursing facilities were left trying to figure out which to follow. Due to these ever changing and often conflicting guidelines for “infection control and care provision”, Skilled Nursing Facilities have been left in a difficult situation with patients and families - and in a place of tension between following all the regulations required by governing bodies while still deeply concerned for the patients and families who are struggling with how and when visits can occur, how the mental and emotional health of these fragile ones and their families is affected and how to best serve the WHOLE patient while making sure all the safety measures are served.

And it’s been a roller coaster for most - but with no end in sight to the ride… and it has been a roller coaster that no one got on voluntarily!

The instability remains, the waves of new variants remain, the mental and emotional roller coaster effect remains and we all want OFF the roller coaster but it does not look as if we will be allowed to get off the ride anytime soon. How I wish this was not the case but in working with the truth as it stands, here are a few thing a family member can know that may be helpful as we all sit tight on this ride:

  1. Understand that the SNF is doing it’s best to communicate with you but has many families that are in the same position as you… so MAKE A FRIEND or TWO within the staff! Most will be happy to help answer question or accommodate a special request as they are able!

  2. Call before you visit so that you know what is allowed at that time. This can help set expectations and create a smoother and more fulfilling visit for you and your loved one.

  3. Be positive! We all feed off each other’s energy! Kindness always goes a long way - especially in situations such as we are all facing. Your kindness can go a long way with staff and helps everyone to want to go the extra miles for you and your loved one!

  4. Ask the Administrator or Director of Nursing for their cellphone. Yes, Most of them will give it to you and would like very much to establish a relationship of mutual respect and care! (Remember, they certainly didn’t get into this field for the money and they truly care deeply about the work they do.) Send them a text with concerns that may arise and give them some time to check into it for you! They want you loved one to have all they need and they will do their best to address your questions and concerns!

It is difficult enough to walk the necessary but unfamiliar path of LTC but Covid has made it MUCH more difficult for the patients, the families and the caregivers within long term care…We know this!

We can be a light, a help or guide to assist you navigate this roller coaster ride and ensure quality care for your loved one. There are ways that we can help ensure that you are creating a thriving relationship with your loved one’s placement or if you have any concerns, please don’t hesitate to give us a call!

Caring together,

Bryan

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