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I have recently talked to staff to find out nurses at ALF only have their LPN degrees which is 1-2 yr college program. I'd like to hear if others know and would share. Thanks.

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The link I see is for nursing homes. As far as RNs, as I mentoned before, would mean a higher rent. Also it is the states the regulates the LPN or RN staffing. If an RN is required to make decisions or speak to a doctor, or order meds then the level of care means nursing care just like the names implies. Assisted is for care for daily life skills like bzthing, dressing and med supervision.  If the poster finds such a place thzt offer skilled nursing in ALs please let us know
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Better check out your state laws. In a AL where I live, there must be an RN in charge. She has to be on call. In some states LPNs are limited in what they are aloud to do.

Moms AL had 39 rooms. An RN was in charge an LPN backed her up. There were Med techs and CNAs.
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I just find it difficult when the charges are so high and yet the skill level so minimum. The Director of Nursing at NH only has an LPN degree one or two yrs of college. I understand that in the old days there wasn't much education for nurses but now there are many opportunities and many complicated patients living longer. I always just assumed the nurses all were Registered nurses..got that wrong.
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Just for information in case anyone’s interested, here’s a list of the minimum staffing requirements by state. There are quite a few, surprisingly including NY which regulates every breath we take, that have “no minimum requirement” for CNAs. In NY CNAs are certified nursing assistants and they have to go through a BOCES or similar CC training. In Moms NH they then shadow an existing Mentor before they’re allowed to do anything on their own.

theconsumervoice.org/uploads/files/issues/Harrington-state-staffing-table-2010.pdf
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Had one disastrous AL place, I moved Dad to a different one after two scary months.

In both places, meds were given by LPNs (Ohio). The LPNs in both places, for the most part, were great people. The difference was the first AL place was a for-profit chain. They hired young women fresh out of school and were always short-staffed. These poor girls burned out quickly and moved on. Hard to get continuity of care for Dad in those circumstances.

The second AL was a not-for-profit (non-chain) retirement community. They had LPNs who had been there for years, they had adequate staffing. They also had aides who had made the place their career, some had gone to nursing school and came back to the AL as LPNs.

The LPNs in both ALs that Dad was in did not do most of the caregiving, that fell to the aides (PCAs). After the bad choice I made with the first AL place, I asked more questions about staffing when I interviewed other places. I also did an internet search of job postings at each place I considered. That gave me important info about the experience and training requirements the AL asked for in potential employees.

The for-profit chain AL did not require their PCAs have any prior experience or training, at least for the location my Dad had been at. Supposedly, they provided on-the-job training. What that meant was you saw them in front of a computer wearing earphones during their shift, getting “training”. Their aides had the same qualifications to get a job at a fast food restaurant. The aides are the ones to focus on, they will interact with your loved one more than the nursing staff throughout the day.

Good luck in your search.

Debbie1955
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At the SNF where my mom was there was one RN per shift, several LPN’s, and many CNA’s whomprovided care. We found it wasn’t so much the level of education as the level of commitment, a “calling” if you will, to working with the frail elderly that made the difference in great caregivers. There’s a huge difference in those working to be paid and those working there because they feel it’s exactly where they’re supposed to be, I’ve never forgotten the good ones.
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At Moms facility the CNAs provide most of the hands on care. There usually are 4 for 38 residents per floor. They are stretched thin. There is no minimum numerical standard in NY, just whatever is “safe”. There are 2 LPNs for these same # residents who dispense the meds and can handle things like insulin and simple wound treatment. There is 1 RN in a floor supervisory position for these same people. There are 6 floors so this repeats on each floor. There is a Nurse Practitioner which is shared between 2 floors and can write scripts, so there are 3 on site. There is 1 doctor for the building, but I don’t think he’s there full time as I rarely see him.
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There is more to being a competent nurse than a formal education, think of it this way... the earliest nurses had no college at all, they learned on the job. Later nurses began to take classes along with gaining practical experience. Still later most women got their caps after a two year nursing program, only the head nurse or ward nurse had a bachelor's degree. Were the nurses who staffed the hospitals of our childhoods not competent?
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You are correct. The AL is mostly staffed with PCAs. Each state has its own restrictions. For instance MA has a social model. LPNs are not allowed to give injections but the can prepare needles and syringes and supervise the resident to self inject. Families have to prepare med trays and LPNs cannot order refills. In CT has a medical model where RNs can do more in their scope of practice. Guess which AL costs more by $1000?
IF you are searching for a facility, I recommend looking for nurse staff who have worked in a place for a long time. As nurses get older and stay in a place for a while, they really become experts with the geriatric population and learn to work around critical issues.  They are also very familiar with the ins and outs of state rules.
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Are you planning to place a loved one? We need more information about why you’re seeking this information.
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