Staffing in MC facilities

frankay

I have been touring MCFs and getting more confused about staffing ratios. Some of the facilities include the activities person who may be part time, the nursing staff who may not do hands on ADL care or others who may or may not deal directly with the resident. One place included the director. I am trying to get answers on how many staff actually do direct care of the resident on a daily basis. What questions should I be asking? What's important? I feel like the aides are the ones doing the ADL care. Is that correct and is that number the most important? In your experience, what is a good ratio of aides to residents? Any help will be appreciated.

Marta

I would ask an aide.

loveskitties

From my experience, the "aids" are the ones who provide the most hands on care...helping with adl's, getting them from place a to place b, watching over them, etc. This makes the patient/aid ration most important.

There are also likely medtec's and CNA's (certified nursing assitants) and nurses...these folks are more specialized in the care they can give. There are far fewer of these than the "aids".

I would ask for a breakdown, by category, for each shift...knowing that nights have a lower staffing since most patients are in bed asleep.

harshedbuzz

This is an excellent question.

I didn't think to ask this.

My experience: When I toured, I paid attention to what I saw happening on the floor. Dad's MCF was a purpose-built stand alone facility. The building had 4 "neighborhoods" each with 10 or 12 rooms, a central kitchen/dining room and a TV lounge. During his stay, there were generally about 8 residents and 2 FT aides on the 1st and 2nd shift. They had a DON during the day and an LPN on all shifts. The activities director was FT and there was a PT person on the weekend. There were activities from 8am until 8pm with a 2 hour break at lunch. Sometimes the activities person had an assistant for bigger group activities. Both the activities person and even the sales person had been aides at once point and were very hand son as needed.

Another piece to staffing that isn't typically brought up is that most MCFs that allow a resident to age-in-place will require family to bring in hospice or private-pay aides when their LO needs more hands-on care. One a floor with 8 people, if 2 are on hospice and have a bath aides and hospice in and out, that does free up the facility's staff. Two women on dad's hall had private-pay aides come in. One woman had a daughter who spent winters in Florida (mom was home with her the rest of the year) so this aide was her usual one and they'd go out or do activities together.

Another question I didn't ask that turned out to be important was how staff are scheduled. At dad's MCF, they scheduled the 1st and 2nd shift aides so that one had Fri/Sat off and the other Sun/Mon-- this meant dad almost always had a caregiver who he knew and who knew him. There wasn't a weekend team of part-timers aside from the activities person who also covered midweek for the weekly lunch out.

HB

Ed1937

Good question. I think facilities with the same number of people working there, and the same number of residents, will sometimes give different answers to that question. In other words, some facilities are more honest than others. So I think a better question to what is the staff to resident percentage might be what is the aide to resident percentage, since they will be the ones responsible for most of the daily care. Then you could ask the same about other more skilled workers. Also maybe just as important is how happy are the aides who work there. The answer to that question should be answered by the aides themselves.

frankay

Oh my gosh, such good information. Thank you. The more I look and ask questions, the more I'm able to hone in on what's important. I really want to keep DH home until the end but after reading about everyone's experiences, I know that may not be possible. Plus I keep thinking, if something should happen to me, I can't put this off on my children who have busy lives. I just feel better having facilities in mind when needing to make that decision. There's so much to think about added to daily home care, it's overwhelming. Your thoughtful information is so helpful.