Long-Term Care Survey Alert

Is your facility grapevine always rattling with complaints about short staffing, even though you're meeting state staffing mandates and other staffing benchmarks? If so, staffing levels may not be the issue at all.

"Oftentimes when staff or administrators say the facility is 'working short,' they really mean that the staff is working without enough information, clinical skills, effective time management or collaboration," says Beth Klitch, president of Survey Solutions in Columbus, OH.

Or nursing staff may be indirectly signaling a need for more recognition of the very difficult job that they do.

Whatever the issue, administrators must get to the root of the problem and quickly, cautions Patty Jamison, principal of Innisfree Healthcare Associates in Plymouth, MI. "Dissatisfaction among staff can quickly spread to dissatisfaction among residents and families." Truly disgruntled staff may even complain quietly to surveyors that the facility is short staffed, which could land your facility with an F tag (F353) if surveyors find a quality of care deficiency.

To figure out what's going on, the administration should take a hard look at the facility from the caregiver's perspective, Jamison suggests.

Are supply closets properly stocked? Are the proper tools easily accessible and in working order for all staff to efficiently complete their daily tasks? Do staff have a private area to relax on breaks where they can grab a snack or eat a meal without interruption?

"When staff members are rushed through tasks, unable to complete them or take a break without interruption, these complaints will often surface as feeling 'short-handed'," Jamison notes.

Facilities might also consider establish a regular forum to funnel complaints directly from staff to administrators. This approach can help resolve issues before they fan into widespread dissatisfaction and survey disasters.

Jamison reports that some facilities have created panels comprised of staff and administrators that meet regularly outside the facility for coffee or a meal.

During the meetings, the staff representatives, who should be well-respected by administrators and peers, bring legitimate complaints from other staff members to the director of nursing and other department heads.

"In order to be successful, these meetings should always have an agenda and not become an unproductive, free-for-all gripe session," Jamison cautions. "Administrators later address the issues and solutions with staff at a facility-wide staffing meeting."