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Comment by alf365 | Hacker News Reader

I remember watching a 20/20 Barbara Walters special years ago on the poor conditions of nursing homes.. fast forward to 2020... My former colleague and I built a QR app-based check-in system for nursing & assisted living - home caregivers to ensure they physically check on each resident as required. I was disheartened & dismayed most facilities just want to turn a blind-eye on the under-staffing issues of their facilities and could care less about improvement...There has to be market-demand to demand change and transparency! I'll keep pushing for change. That 20/20 special motivated me.

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I don't work in a long-term care facility (I do acute geriatric psychiatric care), but I do work next door to one. We're non-profit so we don't exactly fit the mold, but understaffing isn't something that we are aiming for. We're offering incredible hiring bonuses, reaching out on every single avenue. Our problem is retention - we can get a few people hired, but maybe 1/5 CNAs stay, and 1/4 of the nurses. The long term care center probably has slightly better ratios, but most people don't have the ability to compartmentalize or the resiliency to last in the chronically understaffed units. You end up doing the work of 3 people with people who at best are demanding and at worst are physically attacking you and others.

Additionally, even for a CNA, training takes months and months. We get them out on the floor as soon as possible now, which isn't helping with out retention, but reflects the reality that our residents need care. Most of us are pulling 80+ hour weeks just to meet the federally mandated minimum staffing for how many residents we have at a given moment.

Have you tried paying higher than the market rate ( like what you would pay a travelling nurse/CNA) instead of signing bonuses? CNAs make less than amazon warehouse workers in my area. If I'm a nurse, it's only natural I'm going to seek a less demanding patient population asap unless there is a significant incentive not to do that, especially given that every hospital in the country is hiring nurses at all times.

And then you get the $10k/month/person nursing home cost.

We do offer higher than market rates; people just don't want to do the work. CNAs and nurses are very well compensated at my hospital -- however, we are a regional hospital for a fairly rural area, so it's hard to attract talent. The majority of our staff has a 30 minute drive to get to work - if it's any further than that, they'll tend to go to the large city in the opposite direction and get a job there for less money but more amenities. Finding nurses and CNAs that are passionate about geriatric and particularly dementia care is difficult in the best of circumstances.

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