Does anyone know if there's a required minimum number of workers at a NH? -

Does anyone know if there's a required minimum number of workers at a NH?


My GMA in a nursing home just called an Aunt to tell her they've been making her go to bed at 5:30 pm, "because there is only one worker there after that time" and she can't ready the patients for bed alone. My Aunt checked it out, and witnessed an argument take place between a daytime boss and that worker, apparently the person DID actually tell GMA that! The place just got written up, 9 violations, they have trouble keeping help because they pay several bucks an hour less that the other NHs in the area. There are about 45 residents there, can they really leave them in the care of only ONE staff member over night? Is this maybe a good night to try and get an official to "drop by" and catch them at this?

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Check the internet for your states nursing home staffing regulations. There are different laws for different states and for the type of facilities. For example: I just found out that in my state Memory Care Centers and Assisted Living Facilities don't have a specific staff to pt ratio regulation as they are considered Boarding Homes. Not a good situation in my line of thought. NH and Adult Day Centers in my state do have more specific guidelines. Check your states regulations so you'll be clear. In my opinion a staffing ratio of 1:45 is extremely unsafe and needs to be reported to the state.
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Sounds like they really did a sloppy job of managing the bed sore; that's really unfortunate but also inexcusable since it could have been managed better, especially if it spread so much that Mayo Clinic recommended amputation.

Then to medicate her so thing you might caution your aunts on is watching for MRSA - with overuse of antibiotics, in a nursing home situation, being compromised because of the infection....she's at a higher risk for it.

If you can visit her I would do so while it's possible, not so much because of her being in a hospice room but just because it sounds like she could use some cheering up and seeing family could do that.

I would also suggest that both you and the aunts document anything that is amiss; you may wish to file a complaint at some time and that documentation will help.

In the meantime, any support you could offer the aunts to find a better place for her might be helpful, even if there are waiting lists. Your aunts may be in a quandary and unsettled about their experiences and your support might help.

I hope they find a better place for her, soon.
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Thanks for sharing Garden Artist. They do have her on a list for a different NH about 15 miles away from where she is. It's a rural setting, so sadly not lots of stuff to pick from very close. Although it's about a 9 hour drive away from me, so I haven't been privy 1st hand, I think the place really went down hill when they got new owners. Guess a large group of staff all walked out and quit all at once a day last year. I'd be one to fall on the side of the nurses, as my best friend is a nurse, and have several family members in the medical field, have heard plenty about cheap owners of hospitals in my time, seen how much the medical people do care about their patients. I have wanted her moved for quite a while, but I'm a grandkid, a step down in hierarchy from her kids. They are all starting to want her moved as they have been traveling to visit her more and seeing more things. She's technically in "hospice status" even though she's just in her same old room. She developed a pressure sore on her heal after falling over some equipment, then being left sitting in a wheel chair all day while she was injured. They said it didn't need treated or debrided-sp?, only padded and wrapped, which they started doing, some of the times they were supposed too. Then it went into an infection of the bone, osteomyeltis, they call it. Family finally took her to Mayo Clinic, they said either remove the leg, or go home and wait to die. Couldn't believe my Aunts put her back in that place, they put her on some serious IV antibiotics several times, vancomycin, and oxy for pain, fentanyl patch. Said she'd had to many antibiotics, so would take her off that, consider her "hospice" just keep her comfortable for pain. They gave her one or two weeks to live, that was 5 weeks ago. They just started looking to move her to different NH a week ago. (?) I'm sitting here with tied hands, struggling to understand, wishing I'd gone up and stoled her late last fall when the whole thing started like I was thinking of doing. Uggh.
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Nursing homes have different staff to patient ratios; it's an indicator of how much help is actually available for the patients. A 1:45 ratio is probably unique - and unreasonable. There's no way one poor overworked person can handle that many patients.

You can try to get someone to "drop by" but I think I would begin working on finding another place for your grandmother - starting right now.

If this really is the situation, the care isn't going to be anywhere near what you or your aunt want. Being put to bed at 5:30 is probably the tip of the iceberg.

I once chose a facility which on inspection and tour seemed outstanding, but it was a weekend, I had to find something quickly, and I completely forgot to ask about staff to patient ratios. When I realized how bad the situation was, I had to act quickly to change facilities, and even though I was successful, there were a few unpleasant days with very poor service, some evidence of incompetency and an upset parent.
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