Will care facilities be closing?

Smilescountry

Hello! I have two parents who are in a small assisted living facility that provides memory care. Almost all of the residents (about 25) have dementia, and several need quite a bit of care and have hospice or home health care, too. This facility has been good for my parents. We hope that Dad can stay there, but he has had two bad falls and currently has two breaks in his neck that are not healing. Dad is approaching the later stages of Alzheimer's. He is strong, can feed himself, still talks, and can walk with a rollater, but he does need quite a bit of help and is charged for the highest level of care. Mom is independent, but I recently had the facility begin administering her medications because there are times when she can get a little forgetful. I say all that because, if Mom and Dad had gone to a facility separately, they would be in two totally different places and not able to see each other easily. They both depend heavily on each other and celebrated 70 years of marriage this year. This is the only facility in our area that can serve both my parents together. I have been seeing on the news reports that all care facilities might need an RN on staff, onsite, 24 hours a day soon. Theoretically, I like that idea. However, where my parents are, there was an RN and an LPN. The LPN was the director of nursing and recently quit. The RN is the administrative director. They have been advertising for more nurses for months, but they don't have anyone interested. Are facilities like this in danger of closing? I would not put my parents in any of the other facilities in my area. We had a horrible experience with a SNF a couple of months ago, and nothing nearby is good. I am beginning to think that, if this place does need to close, that I need to be ready to bring them to my house and hire home care. I don't want to do that, for many reasons, but I am getting concerned. I don't see these two surviving much at all if they are separated.

Marta

I am the NP at a six bed adult family home.

I don’t think you need to worry in the short term. As there is a shortage of RNs nationwide, meeting the requirement of an RN on the premises 24/7 can only be phased in over time; otherwise homes and facilities would be closing all over the country.

ps. The country added one more RN: my 43 year old son just passed the NCLEX.

Quilting brings calm

As Marta said, it’s going to take a long time to phase anything like that in. My parent’s AL has an LPN 8-5 weekdays ( who is also on call) along with other staff - and is staffed solely by resident assistants ( and cooks) evenings and weekends. Some of those might have a CNA title. That’s a long way from a 24 hour RN.

Marta

Medicare’s proposed rule cited a two year implementation for urban areas and three for rural, with exceptions for areas with staffing shortages, after the final approval for the rule. It is a long way from final approval. In the New England Journal today there was a proposal to shorten these grace periods.

Quilting brings calm

@Marta - if this is a Medicare rule, would it even apply to the ALS and MCs that are only private pay? Sounds like it would only apply to Medicare/Medicaid facilities, such as rehabs, supportive living facilities and skilled nursing facilities.