Long-Term Care Survey Alert

On the list: the facility's quality and financial profile.

For one, there's the emotional toll that can't be captured on a spreadsheet. Residents are "crushed" when that one person they counted on walks out the door, noted Jennifer Pettis, RN, RAC-MT, C-NE, in a presentation on customer satisfaction at the March American Association of Nurse Assessment Coordinators spring meeting in Kansas City, Mo.

And "staff who constantly work short and fight fires never fully recover from that adrenaline rush," says Barbara Frank, a consultant in Warren, R.I., who works with the Centers for Medicare & Medicaid Services and facilities on culture change and staffing stabilization. And while some people "may begin to incorporate that 'hero/heroine' mentality into their sense of self-worth," keeping up that kind of pace isn't sustainable, Frank stresses. Eventually staff will burn out.

Also: There is a relationship between how CNAs score the workplace on satisfaction surveys and the facility's quality indicators, said Mary Tellis-Nayak, MSN, RN, in a presentation at the fall 2008 American Association of Homes & Services for the Aging meeting. Evidence shows a high correlation between staffing satisfaction, stability and turnover, and the quality of care -- and between staffing stability and the facility's financial health, she added.

Spend smarter in hard times: "Nursing homes are facing very dark economic times with all the changes to reimbursement" and states cutting already low Medicaid rates, says Gail Patry, RN,C, senior director of quality programs for Quality Partners of Rhode Island, the quality improvement organization in that state. And "if you are hemorrhaging staff" and constantly recruiting new staff, the facility is spending money unnecessarily that could fund quality-of-care or life programs, she says.