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I realize this past year has been hard on everyone, so maybe its just been that, and the fact that with the lockouts, there has been less available family support. My mom is doing OK, most of the caregivers seem to be helpful and do their job compently, if not always how I would do it. I believe most of the frustrations I've had have been pandemic related; comunication and missing items. Hopefully that will be better now that visitation has been restored.
But, when mom moved into Assisted Living in March 2020, this facility had been open just over a year. It has IL, AL and Memory Care. Mom now lives in Memory Care since June 2020, due to dementia worsening.
There have been 2 Directors, 3 Directors of Nursing, 3 Assisted Living Managers, and now I've been informed that the 4th Memory Care Manager has left (she was only there a month!) While there have been a few changes in the staff that works in Memory Care area, it seems there has been less turnover there, but its hard to tell, since most of that time I just saw staff ocassionally if they came in while I was doing a video call with mom.


I guess I should be glad that the place is nice, it's clean, and Mom seems well taken care of. Which I am, of course. Its just frustrating to meet with the manager to try to establish a rapport for good communication and then poof, they are here one day and gone the next. Only one other time did they say, so and so will be leaving us in a few weeks. The rest has been me reaching out to discuss something and getting told they don't work here anymore.

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Turnover is very common in newer facilities. There is a resident number that has to be reached before additional staff are hired. Until hiring, existing staff become overworked and stressed and burnt out. The jobs are very limited a paying, and benefits? Who knows. Do the facilities give the workers enough hours to qualify for benefits?

New facilities have quite the challenge trying to balance expenses and care needed by residents.
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We have a small AL up the street that Mom lived at for 8 months. While there they hadv3 RNs. One LPN that left not long after she was hired. No one replaced her before Mom left. And of course CNA's come and go. My daughter, RN, apllied for the RN job. She came back from the interview and said they didn't want to pay for the amount of work and responsibilities she would have. Less then she was making already. She was offered the job but turned it down.

There is no incentive anymore to stay put. No pensions and businesses feel people can be replaced and experience working for that company is not considered when getting a raise. In my years working, I have seen people work at a job and told their salary is being capped. The person leaves to find a better paying job and the replacement starts out more than the person who left. It happened to me. I left for pregnancy making 15 an hr (35 yrs ago) and they brought in a replacement for 16 an hr with no experience.
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Any turnover is concerning, but that's how it is and will be until state legislators get serious about addressing this issue along with companies wanting to hire the best and keep the best. Some states have developed, or are proposing, an official state plan to improve services and support for people living with Alzheimer’s and their families.

Locally, it begins with a companies' hiring practices in selecting the right candidates and then offering a culture of retention. This applies to both management and direct care workers. This means providing a living wage, health benefits, paid vacations, a chance for continuing education and certification. No one wants to realize they'll never get beyond where they are today. For the first line caregivers, orientation requires more than a 4 hour video to be proficient in what you're doing. Training needs to be person centered and competency based. Employees want to feel that they're important and wanted. I'm sure the residents would appreciate a well trained, dedicated staff, also.
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It's a newer facility. If it is corporately owned by an entity that is not that experienced in nursing homes, they are going through a learning curve and sometimes this is reflected in how they choose and manage staff and work out systems to run the place. If it is owned corporately by an entity that has other NH facilities, I'd be somewhat concerned.

Obviously, the longer the admin has been in place, the better run the facility. This is also true of day cares. My 2 younger sons went to a daycare where the lead administrator had been there 20 years and it showed (as compared to day cares where my first son attended). I picked this day care largely based on her tenure. My MIL is in a non-profit faith-based facility where several of the admin had been there decades, and it shows. The corporate entity under which it is "owned" manages several other facilities. In this same facility however, there is a certain amount of turn-over in medical and aid staffing. But as others have posted, this could certainly be due to the covid impact. In my mind an aid position is a stepping-stone to other types of jobs and so it would surprise me if an aid was there for very long. The floor or head nurses may change due to scheduling challenges and shift issues. Again, could be from covid.
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ALF and MC facilities are not regulated in the same way that Nursing Homes are. You say your Mom is getting good care and that the staff is not leaving. That is great. I find that the administrative at these places, particularly chains, are very put upon. Often administrations have to serve at more than one facility, have to be on call on weekends. It takes huge dedication to do this, and now there are even more concerns with them having to deal with covid.
If you are happy with the care I would not be concerned, but you may get somewhere speaking quietly with those working on the floor doing the jobs in cafeteria care and so on, just to see if anyone says. Some little "I am a bit concerned how many are leaving this great place; it must be a really hard job, though". See if anyone bites.
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Zdarov Apr 2021
-she says the staff is leaving.
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I think you could also consider calling the state agency that watches over nursing homes, can’t bring the term to mind, they’re listed in the paperwork that you got. Just make a friendly call saying you like the place, but there may be some management issues going on and maybe they need help or guidance.
This could help the staff, and I’d imagine whoever calls stays anonymous to the facility.
This is akin to calling animal control when you’re not sure things are okay at a residence - people always think they’re turning someone in! You’re just asking the authorities to visit and see what they think, they take no action if things are fine.
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Burnout from covid19 is a real thing but that does sound excessive. As long as the care remains acceptable I wouldn't worry too much, but do keep an eye open because there may be something unpleasant brewing.
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Thanks everyone, its almost a joke at this point. To where if I don't get a reply quickly from a voicemail or email, I wonder if they still work there. The last Memory Care manager still had her predecessors voice mail message when she left, it was that quick.
Mom's doing OK, been cooperating with PT, participating in some activities, and I'm getting to visit again, so I'm just going with the flow, and keeping my eyes /ears open.
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GrandmaC Apr 2021
Gracie61, I feel your pain. My Mom is 95, very hard of hearing, blind in one eye and years into her Alzheimer's journey. She has been in memory care for 3 years and just recently graduated off hospice after 2 years. Her facility was excellent and one of my benchmarks was the length of staff working there. The Executive Director 10 yrs, head nurse 8 yrs etc. Even many hands on care givers well over 5 years. During Covid, there have been 3 new Executive Directors, new head nurse and only a few original care givers still work there. I also had very little communication from them regarding changes ( we live 5 miles away). I could not see her etc for over a year. Now that I am allowed back in the building, I have almost lost it twice. The place is no where near what it was, cluttered, messy etc. Almost all the new clothes I bought for her Dec 2019 were missing. ( she lost 30 pounds in the 2 years on hospice) . None of the blankets, bedspread, lap blankets I had provided and LABELED were in her room etc. A few of the dedicated memory care staff were still there and they are so over worked my heart breaks for them, but no one wants to work in this field right now so they just do what they can. I need to finish this later, sorry
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Salary mentioned in this thread appears to have affected the AL/MC facility that my mom is in. Pay for giving covid testing and vaccines appear to be keeping qualified staff from applying and accepting in house jobs. At least that is the opinion of the director of mom’s facility. There was a mass exodus when there was a vaccine mandate by the facility and staff (vendors) left due to non compliance even though they were given until May 1. I have been frustrated in the staffing change because it was not made known to me. I have been told to communicate with the facility as it relates to mom but I did not get the same communication. As an HR professional, I know they cannot give details, but they can let me know that staffing has changed and let me know the new contacts. I sympathize with the 24 hour facility and am grateful that the chef is still there. Food, delicious food is very important! :) I am grateful for my faith and trust in God and pray for their quick resolution to the staffing and training. I know I am not in charge and prayers for wisdom have been answered. Mom safe and cared for is primary. The facility needs our prayers. It is a hard job but when it is fully staffed, the staff can each do their own job with no added responsibilities due to staff shortage.
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I have been in the senior care industry for the last 7 years. High turnover rate of admin jobs is very normal. I would be more concerned if there was turnover in positions like social services, director of nursing, and activities director.
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kibooki Apr 2021
Hi Chris.

That's exactly what I've been seeing at the facility where my mom lives. First it was the head nurse. Then the activities director, business manager, and another patient care position.
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