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So if you have 19 beds of patients who have broken hips legs ankles etc how many CNAs are needed to take care of the patients-3,4,1,2?

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In your State looks like 2. And that depends on the shift. I posted NJ because I live there and it came up the first thing. NC has a higher ratio. I was really surprised.

"The New Jersey bill calls for: 1 CNA for every 8 nursing home residents during day shift (typically 7 am – 3 pm) 1 CNA for every 10 residents during night shift (typically 3 pm – 11 pm) and. 1 CNA for every 16 residents during overnight shift (typically 11 pm – 7 am)"

Since COVID there is a shortage of CNAs.
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In the US you will need to check your state dept of health website to get the rules for your particular type of facility (AL's and LTC will have different ratios). NJ raised the ratio in 2021. That will give you the legal status but as had been said the reality even pre-covid is a totally different things. CNA, household maint (laundry et al) and kitchen help are historically the lowest paid members of the nursing fields (hospitals, ALs, MC, and LTC). Now regardless of what you pay people, you are always going to get some lazy losers in the bunch (look at some high level managers and CEO's to prove that) but even without the lazy people, who can live in one of the high price states like NJ on $14/ per hour? So people take a second job (no they are not supposed to but they have to feed their families and pay rent) so they have one job for 8 hours and a second job for a 4-6 shift. This leaves little time for sleep so when they do show up for work, they can put the Grinch to shame. Sometimes it is overwhelming so they call out sick. That puts a little more stress on the people who are at work and have to cover. Often they get hurt trying to reposition a patient so they are out for that. Because they make a low wage any car they might have is not well maintained so we get call outs because they don't have transportaton (unless you are in an urban area, mass transit doesn't really exist in the US so forget taking a bus or light rail to work and Uber is ridiculously expensive.... for anyone except the really well off). Since covid there has been a tremendous shortage of staff across all industries. I don't know where all the people have gone but they sure aren't applying to all the job for hire signs that I see on every street I drive by (everything with the exception of Amazon is about $15/hr). So the reality is that despite what the state regulations require, on any given day.... base medical care in the form of CNA's and kitchen help is very likely to be much less than the legal requirements. It's sad but it's a reality in the US at this time.
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The NH I was in 1 to 6 on days. Nights 1 to 10. They had an extra floater on day shift to help out. Bath aides were assigned 6 patients a day for baths. Easy to get help because a lot the residents refused bath.
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Countrymouse Feb 2022
Yup, you can get through a task *really* quickly if the resident doesn't want to do it! :)
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You can probably most easily get the answer by call your state ombudsman for long term care facilities. There might be a different answer depending upon whether it's a free-standing rehab or part on an AL or c NH.

But yes, staff shortages all over here as well.

https://www.ncdhhs.gov/divisions/aging-and-adult-services/long-term-care-ombudsman-advocacy-residents-long-term-care-facilities
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Oh dear, I don't like the sound of this question at all. What's happened?

The statutory requirement that is your answer will be lurking somewhere on your state's governmental website. Go to it and search for phrases such as "staffing ratios in rehabilitation wards" until you get a result that looks promising.

Then there's reality. Here is how part of that works, observed in a community rehab team in a pretty rural backwater in England. These jobs are pressurised at the best of times, and hysterically badly paid. Then Covid, so that we can't meet up, can't work or travel together, can't see one another socially. Then people are off work ill, so there's more pressure on the others. So people leave. So there's more pressure. Then the managers are under pressure because we're not meeting our performance targets, so they give us grief and exhort us to work harder and meet higher standards. So people get understandably upset about that and even though they were handling the pressure they don't like the ingratitude and they leave.

Then they send us a questionnaire asking how well our employer looks after our mental and emotional wellbeing. I needed a good laugh.

So, in a hospital in America with 19 beds to the ward and how things are right now - how are they where you are? - there will be the statutory staffing requirement and then there will be how many workers are still standing. The numbers may not match up.

What's happened? What else might be done about it?
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