Nursing Homes Squeezed by Medicare Cuts

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thanks for the insightful comments. I made a fake name/state for my own protection, just in case. I've worked in a nursing home (private) over a decade, I'm a therapist. We've never had the glove and soap shortage earlier posters mentionned. I suggest you call and report that to a watch agency in your sate. That is NOT ok to not have those products. I feel for you who are CNA's who bear so much of the burden. Recently "lost my job" due to outsourcing of our dept. This was painful in many ways though I was fortunate to be hired with the new company. However it is frustrating to see that it seems to be so much about money and the RUGs as another poster mentionned. I am in this career to love/care for and serve the elderly and help them be safe and as independent as possible in their senior years. My role is NOT to make money for the new company. However as someone else mentionned, it seems more about the "productivity" and less about good patient care. On a recent day, due to the documentation, I stayed "off the clock" nearly 2 hours to try to catch up. And I stayed over an extra hour on the clock. I will be in trouble for not finishing, yet I'm not supposed to work off the clock either. I will be finding a new job in the near future. Hang in there. We all work hard in our jobs, I do hope the powers that be will realize this and help us do the best for our seniors.

fake name and fake state for this thread of TX 12:04AM March 23, 2012

I work as a CNA in a nursing home. The care we provide, rather the care we are "able" to provide, is pathetic, and getting worse all the time. We have days where there are no incontinence products in the building, and we are then told that we are "wasting" the products. Yet we are continuously told how we will be disciplined if we are not taking adequate care of the residents, i.e., toileting every two hours and changing soiled incontinence garments. Soap? What is soap? Another item we are told is out of stock because the budget for the month is over. Since October 1st, a nursing home that I used to enjoy working at is looking more and more like a ghost town.Our census continues to decline, therefore our staff/resident ratio is cut even further, leaving most CNA's with a 12:1 ratio on the PM shift. That's not so bad if a good portion of the residents in our group are independent or semi-dependent, but if you toss in even one resident who has severe dementia, including "sun-downers" and you have a real mess on your hands. It's pretty difficult to wash residents up and spend the time with them that they need, and deserve, and pay way too much for, when you have a resident with Alzheimer's out in the hall standing up from his or her chair and setting off the chair alarm, trying to break out of the building, and wandering in and out of other resident's rooms. You people at the top, whoever you are, you just have no clue what life is like for the residents of these skilled nursing homes; you have no idea what outstanding work the staff continues to provide, despite the fact that as of late, we have had our pay cut, our wages indefinitely frozen, loss of paid days off, and less staff to work with on the halls. Come and spend a weekend as a nurse or CNA on a dementia unit and see how you feel afterward. I know how I feel...angry and sad, so very sad, that our older adults are not cared for as well as doggy day care attendees.

Claire Faville of WI 12:14AM February 07, 2012

Nate of Wa, this cut has to do with the "health care bill" which republicans were against, have you been living under a rock?

john of MI 10:40AM December 23, 2011

For anyone who thinks this is a problem, and still willingly votes for Republicans ... shame on you.
All they know is "government spending = bad". They have no clue that government programs help a lot of people, and those people are hurt when you cut budgets, so that the richest Americans can still keep their Bush tax cuts.

Nate of WA 3:41AM October 20, 2011

This is the most insane cut I have heard of in my life. Healthcare is for people that need to be cared for. I work in a nursing home and have been for about 10 years. This cut is affecting more people than the elderly. It is the worst for them but also for the employees that have to care for them. My mom, sister and I all work in the nursing home. My sister and I were just informed of the salary freeze we are on for the next year. That isn't a big deal really it could be worse. My mother is the beautician and she was just informed she would loose her job because medicare cut paying for their hair to be done. So what will she do? The biggest thing that grips my butt is the elderly. They worked their entire life and payed into SSI and Medicare for what to be given the shaft in the end. Its sad enough to know that I'm working for benefits that wont be there when I'm old. I believe the government is going all wrong in these cuts. Getting personal I have at least 5 family members that use and abuse the government daily. They are all perfectly capable of working but choose to sit on their rear and draw food stamps, tanif, section 8, cash benefits, medicaid, etc. They then turn around and sell most of these benefits for DRUGS (meth and marijuana). I think the whole system needs to be revamped and start from scratch. First of all their needs to be a system like unemployment for these losers. They shouldn't get food stamps because they don't want to work. I work with people that are single moms that work and go to school and still can't catch a break. They can't get assistance with anything because they make a piddly thousand dollars a month. So the government pretty much is saying to everyone QUIT your job and WE will take care of you. Shame on your government for making life so easy for our DRUG ADDICTS!

Erika Bauer of MO 11:02AM October 10, 2011

All I can say is I pray for the decision makers and God will handle them on Judgement Day. For all the healthcare workers who have not lost their job due to senseless budget cuts stay strong and do whats right to those that are in need of our help!!

Texas_Tee of TX 6:31PM October 09, 2011

I have worked in long term care for over 20 years of a 30 year career. I am often seeing Nurse Assistants with over 10 residents to care for per shift. If you break that down, you are looking at less than one hour of care per resident per day shift. Yep, less than one hour per shift to feed, dress, position, take to the bathroom, talk to etc. If you can not eat a meal in 10 minutes, you are out of luck. On the other side, the CMS regulation manual and interpretive guidelines have grown over the years to the point of excessive regulation. The QIS survey process just keeps surveyors in the office filling out forms on a computer. I have seen more I/J tags given for ridiculous issues...yet they miss the fact that the 'halls' of the nursing home are deserted of nursing assistants. Give the surveyor a good nursing note...and an updated care plan and they are happy.
Whatever happened to care? healthCARE!! All we worry about is money and avoiding survey citations. Those of us left in the industry have daily expectations of unrealistic productivity and quality standards. We are at our breaking point...physically, emotionally and mentally. The materials we have to work with are dilapidated and in disrepair. Administrators become upset when we request basic items. I heard of a building last week where nursing had to bring in their own gloves because the facility was not buying them due to a denial of payment from CMS. Please help those of us still working in long term care and the residents who we care for!!

MD of PA 9:55AM September 02, 2011

Lawmakers do not understand how much nursing home patients need extended rehabilitation. If they can improve in their ability to function physically more independently or with less assistance before going home, complications at home will be reduced. They will have less risk of falls, less chances of skin breakdown and joint contractures. These secondary problems become costly to the system. A simple incident such as tripping over a bathroom rug can lead to disabling fractures that are hard to resolve. In regards to concurrent and group treatments, I have witnessed the benefits of both. Patients engage with others in the setting and learn from interacting with each other. Since repetition is required for this population to learn new task, it is quite important to place them in the higher RUG level if possible.

Audrey Oshea of FL 9:45PM August 29, 2011

With no warning, I was laid off, and was given the opputunity to be rehired;as a new employee. I lost my title, my seniority, my benefits, and my health insurance. I was told that I was a valuable employee, and am being forced to take the offer enforced by a sworn statement of release of liability, and am suppressed by a signed "Gag Order". If C.M.S. truly believes that the care towards the geriatric population will not be compromised, they are as sadly mistaken. The offer extended to me, replaces 4 full time employees with in our work force! The only good news; my residents are only lossing 40 hours of direct patient care by one corporate decision. The bad news, how many more confidential offers are on the offering table?

V of GA 8:09AM August 27, 2011