My father is in a nursing home that, like many others I'm sure, is chronically short-staffed. It's recently under a new administrator & a new Director of Nursing and, despite their fancy promises of 'good things to come', good things keep disappearing, like CNAs to actually take care of the residents while the administrator and DON happily hire administrative/office staff & regularly schedule/have only 3 aides for 50 residents... sometimes less.
This means care is faltering, most recently showers. My father's was skipped on Monday and when we asked about it, the DON told us there weren't enough aides to do his shower and she'd 'see' about getting it done later and asked us to have patience (including with his care plan not being followed) because 'we're trying to sort things out.'
He didn't get a shower, which actually does go against his care plan, and he's due for another today but was dressed (he usually gets showered before he gets dressed) when I talked to him & hadn't go one.
With their 'we're short-staffed' excuse that has become a crutch, I'm not hopeful.
So what can I do? I think there are rules here in PA about two showers a week but how much leeway is there? And when do I go beyond the administrator and DON to the state or something?
Any advice is appreciated.
isthisrealyreal - I want to file a complaint now, on their staffing levels, but my parents are resistant for fear of retaliation or the place getting shut down. I'm not sure how to file, but also respect them. PA regulations are kind of complicated, in that it's less about ratio and more about... does the resident get 2.7 hours of one-on-one care per day.
I suppose they can twist the math to show that they do. The administrator claims the goal is a 9:1 ratio for first shift, 10:1 for second... but that's also a PA law coming into effect over the next few years. Which is good, but also kind of frightening because what happens when they can't meet that?
cwillie - I know sometimes unforeseen issues will happen and I know all LTC is struggling. PA requires the Resident Bill of Rights to be posted too, and I am familiar with it because we've contacted the ombudsman about other things & she gave it to us. But as I said above, my parents are worried about retaliation if we cause too much more trouble... good trouble, though, since we're just demanding his rights be met.
Anyway, his regular aide was back on Thursday and he did get a shower... she was apparently flustered because her residents were skeptical she'd give them showers & she's never skipped any. And then she apologized to them for not having gotten showers Monday.
There's a "Meet & Greet Town Hall" with the new administrator & DON tonight. I'm going, even though I've talked to them a lot (never with a positive outcome), and maybe that'll help me settle on what to do. If they let anyone else saying anything & if they promise/lie to a larger group and not just me...
Thanks again, all, and sorry for rambling.
There are minimum staffing regulations and I have never seen that 3 actual caregivers is sufficient to care for 50 people. The greatest ratio that I have seen is 15:1, which is pushing the line.
It may be time to look into different facilities. If the obvious things aren't being taken care of, what is going on behind the scenes?
feelinglost - an occasional missed shower due to unforeseen staffing issues is understandable but if it's happening often then that is unacceptable. It seems as though long term care is facing a staffing crisis everywhere but it is up to each facility to figure out a way to deal with it, whether it's through bringing in outside agencies, offering better pay and working conditions or something else. Where I live a residents bill of rights must be posted prominently in every facility, and failure to provide mandated care can result in fines or even a loss of license to operate.