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I realize this past year has been hard on everyone, so maybe its just been that, and the fact that with the lockouts, there has been less available family support. My mom is doing OK, most of the caregivers seem to be helpful and do their job compently, if not always how I would do it. I believe most of the frustrations I've had have been pandemic related; comunication and missing items. Hopefully that will be better now that visitation has been restored.
But, when mom moved into Assisted Living in March 2020, this facility had been open just over a year. It has IL, AL and Memory Care. Mom now lives in Memory Care since June 2020, due to dementia worsening.
There have been 2 Directors, 3 Directors of Nursing, 3 Assisted Living Managers, and now I've been informed that the 4th Memory Care Manager has left (she was only there a month!) While there have been a few changes in the staff that works in Memory Care area, it seems there has been less turnover there, but its hard to tell, since most of that time I just saw staff ocassionally if they came in while I was doing a video call with mom.


I guess I should be glad that the place is nice, it's clean, and Mom seems well taken care of. Which I am, of course. Its just frustrating to meet with the manager to try to establish a rapport for good communication and then poof, they are here one day and gone the next. Only one other time did they say, so and so will be leaving us in a few weeks. The rest has been me reaching out to discuss something and getting told they don't work here anymore.

WOW that is huge I would be worried. Not to kick you while your already down so to speak, but WOW. Listen to you gut. Its telling you this for a reason. Your mom has memory alignment and can't probably always tell you if something happens or goes wrong. I would be worried about a doggie care center that changed that many care givers, let alone someone taken care of me mum.
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Reply to Hodacat
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Imho, while turnover is not unusual in these type work environments, you could always investigate online ownership of facility.
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Reply to Llamalover47
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High turnover in staff may be expected for the next year with COVID pandemic still an issue.

I am an RN. I will returning to the field, though not in residential care. ALL facilities are having higher than normal staff turnover. Some older staff are choosing to retire now. Some younger staff are choosing to return to school and change fields. Other are reevaluating how their administrations have treated them under stressful conditions. This pandemic has been very stressful for healthcare workers at all levels and types of careers.

So I keep asking myself:

Is my loved one safe?

Are staff attentive?

Is my loved one clean, well-fed, comfortable?

Are the majority of their valuable still in place?

If yes, seems like this may be a good fit for now.

Keep reaching out to the facility and just ask who is in charge of your loved one's care. If there are concerns, ask and keep elevating the question to higher personnel until you get an answer.
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Reply to Taarna
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While it is frustrating to have "contacts" and then they magically disappear. Mom's place was very old buildings, non-profit with endowments. They made the decision to tear down and rebuild rather than renovate. It is also IL/AL/MC (not all of these are CCRC - this one certainly wasn't.)

While there were some staff changes, some chose to leave, others were asked to leave, but most of the care-givers have been fairly consistent. When visiting was allowed, there were some new faces, but plenty of "old" ones as well. Having certain contacts leave, like the nurse in charge of MC and the person doing the billing, certainly put a damper on things, especially when there is no notice! Since it's personnel issues, they aren't about to say so and so quit or this one was fired. At the very least they should send out notice about the NEW person taking over the position!

Since you indicate your mom appears to be well cared for and relatively happy, that is a comfort. It is the one thing I could count on. No matter what time of day or what day I showed up to visit (before lockdown), she was always clean, well-fed and relatively happy. I never gave indication of when I'd be there, so they couldn't just "prop" her up.

Despite misgivings by a select few on this forum, not all facilities are doom and gloom for our LOs. It is incumbent upon us to give the selection of a place proper consideration and know what is provided, as well as be there (when it's allowed, due to virus) to oversee their care.

If they have your email, I would request the director of the facility to ensure at least the responsible family members to receive email introducing ANY new hires. It's not their job to report when/why someone leaves, but they SHOULD be informing you, the person overseeing care, when there is a new contact!
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Reply to disgustedtoo
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I understand where you're coming from. My mom is in AL, she and dad moved there in 2018. Dad had to move to SNF shortly before his death.

Since 2018 there have been 5 directors and each of the following directors seem to be in the position for less period of time. The 4th one was by far the best but was in trouble with CEO when she fought to get the best for her residents and got fed up and left. The newest one has been ok so far but isn't as qualified as the past directors were. The middle 3 were RNs. The first wasn't an RN but an RN was also on staff of AL. Law of MO only require an RN 8/wk. So this one isn't an RN and the RN assigned comes as needed. While she does ok where she is the facility isn't the best - but affordable. It was originally not for profit, but church sold it to a for profit just after they moved in and services offered have declined. To make matters worse no one can contact corporate.

I do know when my husband and I were shopping around to move mom closer to me before COVID that many of the places were viewed had turn over in staff - esp the director chair. I was told it was a growing industry with new facilities offering new opportunities. I don't know. But it is time for me to get off my backside and get to work getting mom placed in a better facility. I was told by a couple of places I contacted on computer she may actually be able to move back to IL as what she needs now is assistance with med set-up which would be an additional expense and laundry assistance, which if she was closer to me I could handle easily.

If the facility is clean and she is well cared for I'd just keep an eye on how things progress. But it's always hard to break in an new director.
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Reply to cweissp
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Some of the turnover does sound a little high. T/O in AL Managers/ Sales/Marketing are sometimes high because of the need to keep occupancy levels high. Since it has multiple levels of occupancy (IL;AL;MC and I am presuming LTC) this sounds like it might be a CCRC. I'd google them and find out who is the current owner. A new owner or a new company might be bringing in their "own" people or just finding their way. For profit companies tend to change management more often than not for profit (again .... they are more than a little concerned about profit). Changes in DONs are a bit more rare. They generally make a decent salary across the board and basically run day to day operations. MC managers also seem to stay a little longer so that many changes within a 12 month period is unusual. Possibly the upper level management atmosphere is so toxic they all keep quitting and that means HR needs to get involved in finding the right mix..... quickly.
Surprised that more changes have not been seen at the lower levels of care -- the CNAs, kitchen, laundry and maintenance staff. As other have very rightly pointed out ... the salaries are abysmal, the work is hard and long. Even with good salaries it is always tricky getting good staff and when the salaries are bad.... well, you almost have to take what you can get and sometimes that's just not good. Most staff will have to work two jobs to make ends meet and sooner or later they just burnout. You end up with some people who are lazy or who will call out with only an hours notice (because they are lazy or because the other job they have has called them in for a day with additional money); this means the staff that does show up has to work extra hard and possibly do a double shift (16hours) to keep things going for the residents. Sooner or later those good souls burn out too. Pay rates in the better facilities start at $14/hr but in some of the well regarded ones kitchen staff can start as low as 11.50/hr. Of course, if you raise the pay rate, the owners are not going to give up a % of their profits so they are going to pass the pay rate hike onto the residents and the monthly rentals will increase. It's a vicious cycle.

It is good that you will be able to visit in person soon. If you find that Mom is being well cared for it means those lower paid folks are doing their jobs in spite of management changes and that's a good thing. If stuff is happening that you don't like, you may need to anonymously alert the Ombudsman's office or if the facility is owned by a large chain, go above the head of the always changing administrator and contact the CEO. If you decide to install a camera in your LO's room to ensure that she is being taken care of, please consult your state laws first. In some states a camera in a private room is considered an invasion of privacy and may be illegal.
Wishing you good luck.
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Reply to geddyupgo
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If you're happy with the day to day standard of care, leave that bit well alone.

But it is by no means unreasonable for you to expect to know who is accountable and who is leading this community. Can you look whichever company runs it up online?
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Reply to Countrymouse
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I have been in the senior care industry for the last 7 years. High turnover rate of admin jobs is very normal. I would be more concerned if there was turnover in positions like social services, director of nursing, and activities director.
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Reply to SilverChris
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kibooki Apr 23, 2021
Hi Chris.

That's exactly what I've been seeing at the facility where my mom lives. First it was the head nurse. Then the activities director, business manager, and another patient care position.
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It's a business. To us so much more, to them it's a job. So many factors: it's a needed business, and people in these roles are in demand, so they can go pretty much anywhere. People of our generation were brought up by the "greatest" with some ethics and sense of responsibility/obligation. Not the latest generation so much. So if they hear about a similar position elsewhere that pays a bit more, they will jump ship, and who can really blame them. The wages are low, so that the profits of many of these places can be higher. Look up reviews of your place on line. Call your local long term care ombudsman for some input/guidance. If you have to move someone it may be easier to do sooner rather than later in light of any dementia issues. Maybe there is a non-profit facility? Sometimes religious based. You are wise to want to make connections with the daily staff, and have a reliable link. You also might want to google this particular home or their ownership and find out if there are issues, financial or otherwise. For your own peace of mind don't settle.
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Reply to gdaughter
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I think you are right to be concerned about the turnover. Does your mother have a casemanager? Is the casemanager stable and responsive? What is your "ask"? Would you be satisfied if they proactively let you know if your contact is leaving and give you information about the replacement? If you are concerned about the turnover, is this part of a chain of facilities? If so, maybe you can express your concern further up the line. Would you move her to another facility if they don't solve the turnover problem?
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Reply to NancyIS
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I would be concerned to have a Turnover of one every year
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Reply to bevthegreat
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Propbably Money.

Next time, ask not that you'll get the real answer but you may get an answer from someone else that works there.

You should install a camera in her room so you can watch how she's really doing.

The thing with dementia, your loved one won't remember who treated her badly.

Prayers
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Reply to bevthegreat
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Gracie61 my experience with my husband when he was in memory care was not good because of turn over of all levels of staff. He only lasted 5 months before being hospitalized for what was called community pneumonia and passed away 2 weeks later. Do research on the facility and the management company. Don't let the location fool you. My husband was located in what some people would say a better community but the facilty was trash. I wish you the best!
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Reply to alzdone
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gdaughter Apr 23, 2021
I victimized myself by picking a lovely place (from the outside) when pushed by hospital staff to go to rehab last fall. Yes, my priority was to be close to home...but the care was lousy, in a word, the food was so bad someone dropped off fast food for me once and once the heck out of there, it took no less than 3 trips back because of their incompetent help who didn't follow through sending me a statement of my account. NOW I am trying to get more information for what I believe are fraudulent claims with the insurance since I am being left with bills some of which are being turned to collections.
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Seeing the same at my husbands AL facility.  Remote management for the most part right now but care, cleaning, food etc all seems to remain high standard.  Have been told by May there will be new manager/sales manager team who happens to be husband and wife on site.  I do wish these places would pay more...the staff often fill multiple roles and are very kind to the residents.
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Reply to onholdinmidwest
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Salary mentioned in this thread appears to have affected the AL/MC facility that my mom is in. Pay for giving covid testing and vaccines appear to be keeping qualified staff from applying and accepting in house jobs. At least that is the opinion of the director of mom’s facility. There was a mass exodus when there was a vaccine mandate by the facility and staff (vendors) left due to non compliance even though they were given until May 1. I have been frustrated in the staffing change because it was not made known to me. I have been told to communicate with the facility as it relates to mom but I did not get the same communication. As an HR professional, I know they cannot give details, but they can let me know that staffing has changed and let me know the new contacts. I sympathize with the 24 hour facility and am grateful that the chef is still there. Food, delicious food is very important! :) I am grateful for my faith and trust in God and pray for their quick resolution to the staffing and training. I know I am not in charge and prayers for wisdom have been answered. Mom safe and cared for is primary. The facility needs our prayers. It is a hard job but when it is fully staffed, the staff can each do their own job with no added responsibilities due to staff shortage.
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Reply to Tandemfun4us
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I think you could also consider calling the state agency that watches over nursing homes, can’t bring the term to mind, they’re listed in the paperwork that you got. Just make a friendly call saying you like the place, but there may be some management issues going on and maybe they need help or guidance.
This could help the staff, and I’d imagine whoever calls stays anonymous to the facility.
This is akin to calling animal control when you’re not sure things are okay at a residence - people always think they’re turning someone in! You’re just asking the authorities to visit and see what they think, they take no action if things are fine.
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Reply to Zdarov
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Thanks everyone, its almost a joke at this point. To where if I don't get a reply quickly from a voicemail or email, I wonder if they still work there. The last Memory Care manager still had her predecessors voice mail message when she left, it was that quick.
Mom's doing OK, been cooperating with PT, participating in some activities, and I'm getting to visit again, so I'm just going with the flow, and keeping my eyes /ears open.
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Reply to Gracie61
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GrandmaC Apr 23, 2021
Gracie61, I feel your pain. My Mom is 95, very hard of hearing, blind in one eye and years into her Alzheimer's journey. She has been in memory care for 3 years and just recently graduated off hospice after 2 years. Her facility was excellent and one of my benchmarks was the length of staff working there. The Executive Director 10 yrs, head nurse 8 yrs etc. Even many hands on care givers well over 5 years. During Covid, there have been 3 new Executive Directors, new head nurse and only a few original care givers still work there. I also had very little communication from them regarding changes ( we live 5 miles away). I could not see her etc for over a year. Now that I am allowed back in the building, I have almost lost it twice. The place is no where near what it was, cluttered, messy etc. Almost all the new clothes I bought for her Dec 2019 were missing. ( she lost 30 pounds in the 2 years on hospice) . None of the blankets, bedspread, lap blankets I had provided and LABELED were in her room etc. A few of the dedicated memory care staff were still there and they are so over worked my heart breaks for them, but no one wants to work in this field right now so they just do what they can. I need to finish this later, sorry
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ALF and MC facilities are not regulated in the same way that Nursing Homes are. You say your Mom is getting good care and that the staff is not leaving. That is great. I find that the administrative at these places, particularly chains, are very put upon. Often administrations have to serve at more than one facility, have to be on call on weekends. It takes huge dedication to do this, and now there are even more concerns with them having to deal with covid.
If you are happy with the care I would not be concerned, but you may get somewhere speaking quietly with those working on the floor doing the jobs in cafeteria care and so on, just to see if anyone says. Some little "I am a bit concerned how many are leaving this great place; it must be a really hard job, though". See if anyone bites.
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Reply to AlvaDeer
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Zdarov Apr 23, 2021
-she says the staff is leaving.
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Any turnover is concerning, but that's how it is and will be until state legislators get serious about addressing this issue along with companies wanting to hire the best and keep the best. Some states have developed, or are proposing, an official state plan to improve services and support for people living with Alzheimer’s and their families.

Locally, it begins with a companies' hiring practices in selecting the right candidates and then offering a culture of retention. This applies to both management and direct care workers. This means providing a living wage, health benefits, paid vacations, a chance for continuing education and certification. No one wants to realize they'll never get beyond where they are today. For the first line caregivers, orientation requires more than a 4 hour video to be proficient in what you're doing. Training needs to be person centered and competency based. Employees want to feel that they're important and wanted. I'm sure the residents would appreciate a well trained, dedicated staff, also.
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Reply to sjplegacy
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We have a small AL up the street that Mom lived at for 8 months. While there they hadv3 RNs. One LPN that left not long after she was hired. No one replaced her before Mom left. And of course CNA's come and go. My daughter, RN, apllied for the RN job. She came back from the interview and said they didn't want to pay for the amount of work and responsibilities she would have. Less then she was making already. She was offered the job but turned it down.

There is no incentive anymore to stay put. No pensions and businesses feel people can be replaced and experience working for that company is not considered when getting a raise. In my years working, I have seen people work at a job and told their salary is being capped. The person leaves to find a better paying job and the replacement starts out more than the person who left. It happened to me. I left for pregnancy making 15 an hr (35 yrs ago) and they brought in a replacement for 16 an hr with no experience.
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Reply to JoAnn29
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It's a newer facility. If it is corporately owned by an entity that is not that experienced in nursing homes, they are going through a learning curve and sometimes this is reflected in how they choose and manage staff and work out systems to run the place. If it is owned corporately by an entity that has other NH facilities, I'd be somewhat concerned.

Obviously, the longer the admin has been in place, the better run the facility. This is also true of day cares. My 2 younger sons went to a daycare where the lead administrator had been there 20 years and it showed (as compared to day cares where my first son attended). I picked this day care largely based on her tenure. My MIL is in a non-profit faith-based facility where several of the admin had been there decades, and it shows. The corporate entity under which it is "owned" manages several other facilities. In this same facility however, there is a certain amount of turn-over in medical and aid staffing. But as others have posted, this could certainly be due to the covid impact. In my mind an aid position is a stepping-stone to other types of jobs and so it would surprise me if an aid was there for very long. The floor or head nurses may change due to scheduling challenges and shift issues. Again, could be from covid.
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Reply to Geaton777
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Turnover is very common in newer facilities. There is a resident number that has to be reached before additional staff are hired. Until hiring, existing staff become overworked and stressed and burnt out. The jobs are very limited a paying, and benefits? Who knows. Do the facilities give the workers enough hours to qualify for benefits?

New facilities have quite the challenge trying to balance expenses and care needed by residents.
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Reply to gladimhere
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Burnout from covid19 is a real thing but that does sound excessive. As long as the care remains acceptable I wouldn't worry too much, but do keep an eye open because there may be something unpleasant brewing.
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Reply to cwillie
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