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Keaton Asked September 2014

What do caregivers ordinarily get paid in senior memory facilities?

I was informed the other day that a caregiver who works in my mother's facility gets less than 12 dollars an hour. I was shocked, considering the workload that I witness. Is this usual practice? i would like to know how the financials break down in some of these facilities. I realize they are private businesses, but is there no oversee?

Keaton Oct 2014
This was an interesting article related to profit. (a year old now)

anonymous158299 Sep 2014
the govt tries to keep us all hungry so we dont take much time off work . i worked for an old gal once who told me a comical story . her manufacturing company decided to open up shop in small town tennessee ( or equivalent ) . they figured these hill folk needed jobs badly and wouldnt miss much work . guess what happened on beautiful spring mornings ? yep , hilljack is goin fishin come h*ll and / or high water ..
back on subject i think nh workers should be paid a decent liveable wage . it is incredibly hard work that they do . i saw a shift nurse last week come to the front door as an old fellows family members were leaving . she knew he would need to be calmed down and redirected , which she did with incredible compassion and skill . the family had no idea what the old guy did after they were done visiting .

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Keaton Sep 2014
Well, call me an eternal optimist. Sometimes it just takes a paradigm switch, but I believe there are passionate people who do enjoy this work. I know I have changed to be somewhat more compasionate by being with my mother and others who need help. You come to see the value of working with the elderly and people with dementia. They are extraordinary in a way that we don't really understand, but I can see how someone might want to devote their career to this. Not to put down restaurant work, but I just don't see the comparison of flipping burgers and caregiving (although I am sure there are people who are expert in this field as well!) I liken caregiving more to teaching which is at least regarded to have some value still in our culture. We need to address what is happening in these facilities. I realize Frontline did a documentary and there have been articles but I see so much neglect, even though the caregivers work so hard. This is a top of the line facility. I see people sitting in chairs weeping or wandering about half dressed because there is not enough help. Hiring dedicated staff with decent wages is one way to battle the problem, in my humble opinion. I don't buy the idea that there is not enough money. Let the garden go a bit and pay the caregivers first. Forget the new pillows or pumpkin decorations and put money in people first. Okay --enough of my tirade! hah!

igloo572 Sep 2014
FreqFlyer - fabulous detailed information. You go girl.

At both the 2 NH mom has been in and her old IL all in TX, most of the work is done by minimum wage workers. A few may be making $ 12 -18 hr. Overwhelmingly Hispanic. Nursing staff other than the DON and her two main RN assistants are mainly either Carribean area immigrants (I imagine they are hospital based RN education rather than BSRN stateside & I bet they make no where near the wage of a hospital RN) or male & were formerly military medics. The RN for mom's hospice is from Barbados. The ones who seem to make a decent wage are the social worker (so they have BSW or MSW); the head of dietary (actually is an RD); the DON & her two assistant DON's; the head of maintenance is an actual licensed electrician so I bet he makes a decent salary. The vast majority probably are not making a true living wage but just getting by. What they do and be so positive is just amazing.

If INS were to do a sweep of NH & hit all in one day to go over the I-9 info in details for every worker, they would all need to shut down that night. Much like the hospitality & restaurant industry. Personally I don't know who would do these jobs if it wasn't for recent immigrant labor.

Livelifefull Sep 2014
These comments are all very good.

I am a private caregiver, taking care of one woman (in addition to the care she gets at a facility).

I feel very sorry for these women. (and men), most always have a smile on their face, and they are very nice people, and because of the realities, that in these long term care facilities, they do not staff appropriately, or staff based on guidelines.
1 nurse for 17 - 18 patient's and two aides. Imagine what happens when all need to be wheeled into dinner? After dinner? What about the bathroom? 2 people? Really, and the sad reality, is I see them after they are almost done with there shift, and haven't had a break, and had a 10 minute session to eat food fast. Then this is only their first job for the day. It is hard to see, because they do make a difference, and I will tell you, that management is very hard on them.

They are almost afraid to do anything but smile, and be courteous as they have been drilled "the patient is always right"???? Well, that we all know in the aging, isn't exactly so, there minds are going, etc. etc.

But, I am in private care, because truly, these woman and men make a large difference, and I tried in our state to get the Government, and our Mayor etc. to see, and the Long Term Care Upper Management, but it all comes down to profit, bottom line, and yes, they are a very lean staff, with a larger staff on upper management where they get salaries that are in my opinion way too high. Just an opinion.

Keaton Sep 2014
And thanks Pam. I did not see your comment before.

Keaton Sep 2014
Thank you Freqflyer, Great article and explains a lot. So the statement: "For an average 80-unit facility pulling in $2.75 million in annual revenues, caregiving staffers expenses chew up 17% of that income." made me wonder how much caregivers were paid in 2007 compared to 2014, considering that the 80 unit facility now pulls in $7.68.mil. I don't think they are crooks, Windytown. I'd just like to see a little more compassion in the business and less profit.

pamstegma Sep 2014
FF, the Net Margins are very small. I wouldn't buy stock in any of them. And with the feds cutting back reimbursements, a crisis is in the making.

freqflyer Sep 2014
According to a Forbes's article written in 2007, brand-new nursing home facilities will eat $130,000 to $145,000 per room in start-up costs–or about $11 million for an average-sized location with 80 units....

The article continues... for an average 80-unit facility pulling in $2.75 million in annual revenues, these expenses chew up 17% and 15% of that income, respectively. (Excessive turnover drives those percentages higher.) Next, allot 9% of sales to liability insurance, property taxes and utility bills. Some 8% of revenues will go to pay top-level administrators, accountants and lawyers. Security and maintenance will gobble another 7%, followed by marketing efforts (5%), housekeeping and laundry service (5%), an activities director to keep your residents busy (2%) and transportation (1%). Operating profit margin (before interest, taxes, depreciation and amortization): about 30%.

windytown Sep 2014
Keaton, You bring up some good stats. My mom's in an AL. I've made a few observations that you may or may not agree with. Just my two cents.

Of course every place is different - it's a big world as I'm sure you'll agree. The grounds where my mom's at are pretty big as far as mowing, leaf bagging, etc. Can't be cheap. It's certainly no task for a house gardener, whatever that is. I can barely keep up with my own house garden. LOL

The liability insurance in AL's must be through the roof. I can't imagine what they must pay. My homeowner's insurance is incredibly expensive, ludricrous even.

I'm not trying to defend the places, just in my experience, they are not gouging people. It's their cost of doing business. The government and their regs have made stuff really unaffordable.

Keaton Sep 2014
Thanks for the details frequent flyer. Do you suppose 560,000.00 a month covers those operational expenses? That's what they are taking in at this facility. The appliances is a one time expense w/ some replacement/repair. The grounds can't be that expensive--about as much as a house gardener. I can compare employee costs to a public school system when it comes to food costs, utilities and healthcare benefits. No school with 400 children including preschool spends that much money per month and they serve breakfast lunch and dinner to at least 100 students. Residents pay the rent plus any medicines are charged to the residents separately, including incontinence support. Any extra care has to be paid for in top of the basic rent (about 8,000.00/month) The facility is not paying for that. Residents usually provide the furniture for their rooms and pay for the move.
They do have a sofa and some chairs about. Again that is a one time cost and I am guessing can't be more than 1,000.00 a year for replacements.
I see caregivers doing more than caregiving. They are working in the kitchen, sometimes cleaning, preparing activities, and other duties so their job is much more than companionship and entails many jobs during the day. I would just love to see more transparency.

freqflyer Sep 2014
Oh, I forgot to add the cost of food for the patients, imagine what the facility's grocery bill looks like. The plates, silverware, pots, pans, cooking sheets used in the kitchen. The cost of commercial sized refrigerators, commercial sized stoves, commercial sized dishwashers, and other assorted kitchenwares.

And the cost of pharmacy medicines and over-the-counter medicines. The cost of furniture, bet it is replaced more often then we think. such as mattresses.

freqflyer Sep 2014
brandywine1949, the largest expense a business has is employee pay/benefits. Not only the Caregivers, but the employees who do the cleaning, laundry, the cooking, administration work, rehab employees, activity persons, security, etc.

Then the building itself, the monthly mortgage or rent. If the building is own by the facility, the property taxes. The cost of electricity for a building that size, heat, air conditioning, water, telephone, security cameras, and cable TV service.

Let's not forget the insurance on the building itself, mal-practice insurance, hazard insurance, etc. Sub-contracts for snow plowing, grounds maintenance, and repairs that their maintenance man cannot fix.

Every time a patient relocates elsewhere, that room needs to be made ready for the next patient... thus cleaning, painting, flooring cleaned, items fixed.

Keaton Sep 2014
I wonder how this can be changed. I never see financials discussed on caregiver sites. If the pay was around 20 /hr., with benefits, I think that is fair. Pam, minimum wage is for very servile jobs I would think. These people have responsibility for people's lives. I wonder if caregivers could be courageous enough to address this someday. The reason I think it is important is that care can become second rate very fast if the caregiver does not feel appreciated. I see more and more employees fleeing these institutions for one on one care.

brandywine1949 Sep 2014
The top brass, like the CEO probably make plenty of money. At $8000 per month, the money isn't going to the aides so it must be going somewhere.

pamstegma Sep 2014
According to payscale.com the hourly rate in the US ranges from $8.06 to $15.57 per hour. The oversight is the minimum wage law. The financial spread sheet would add in the cost of benefits, vacation time, training, FICA and supervising RN's to formulate the "loaded rate" which can be double what the actual pay is.

jeannegibbs Sep 2014
You are right, Keaton, the pay level is often shocking in care centers. It is a wonder to me that so many good people are attracted to such careers.

freqflyer Sep 2014
According to one website that does stats for different jobs, it seems the average pay for a *certified caregiver* is between $10.72 and $15.00 a hour. One also has to take into considering if the job offers benefits such as health care benefits, and/or 401(k), which in itself is an important benefit.

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