Licensing thinks your understaffed?

From time to time, even the best communities may be accused of being “understaffed”. Sometimes it is families with unrealistic expectations of care, other times it can be a surveyor or even disgruntled employee making negative comments. It can be frustrating for good providers to “prove” staffing is adequate. Of course, there are formulas and most service planning programs will estimate FTEs, but often a surveyor may want more confirmation of adequate staffing.

Here are some ways you can demonstrate your good staffing plan:

  1. ADL or End of Shift documentation. Are caregivers initialing or signing all work completed? This will help show there are enough people to get the job done.
  2. Satisfaction Surveys. If you conduct surveys on a regular basis, good results would only be expected if residents and families felt satisfied with the level of care.
  3. Call light response times. Can you pull reports to indicate call lights are generally answered within 10 minutes? That is an indicator staff are responding in a reasonable amount of time.
  4. EMAR reports. Most all EMAR programs can show if meds are given outside the appropriate time frame. IF the bulk of yours are on time, that also indicates adequate staff.
  5. Quality indicators. Tracking such things as pressure sores, skin tears etc. can help demonstrate your staff is providing sufficient care to avoid excessive negative outcomes.
  6. Good hygiene. Invite those who question your staffing patterns to look at your residents – trim clean fingernails, well groomed hair, clean shaven, stain free clothing, etc. all indicate staff are performing their job successfully.
  7. TV off—activities going! Don’t forget to show your activity schedule and log. Let others see what great things there are to do throughout the day.

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These are just a few suggestions to demonstrate your outstanding care. Do not hesitate to ask other professionals to substantiate your well run community. Home health and hospice nurses who are in your building day in and day out can often confirm the needs of their client are certainly being met.

2 Responses to “Licensing thinks your understaffed?”

  1. Great suggestions. Proofs are essential to offset assertions by others that may be based only on perceptions or even driven by hidden agendas. In addition train all staff to eliminate from their vocabulary words that imply a community is understaffed. This includes saying “we were short handed” or “last night was crazy”. The fact is there will always be challenges and in those cases “care trumps” non care tasks that can be caught up later. It’s pushing off care – not laundry – that gets good us operators into trouble.

  2. Great input Wade, caregivers often don’t think through the implications of how their words represent the team. Time with residents always trumps laundry, I like it…

    Thanks C&C for the great reminders. It’s so easy to think “well I know we have enough staff so I don’t need to worry about it.” But the tips all point to how I can document and “prove” that we do indeed have enough. So important!

    It’s the small things that make the biggest long term differences. Thanks!

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