Recommended strategies for addressing delays in care caused by chronic understaffing
Requesting advocates share their best strategies for addressing delays in care caused by chronic understaffing. We have all experienced clients pleading for assistance with virtually every aspect of ADL care (toileting, getting dressed, assistance w/ meals, responding to call bells, etc...) as NH staff repeatedly complain that they are «short staffed.» The issue is chronic in most facilities and providers have become complacent with trying to prevent it.
I am asking advocates to share your strategies and innovative interventions that have been successful with providers and staff. I am interested in learning what internal strategies (w/ unit staff, supervisors, directors, admins, etc..) and external strategies (filing complaints w/ regulatory agencies, hotlines, insurers, media, etc...) have worked for you and your clients. Thank you for your ideas!
David Fielding, BCPA, MPH
Engage Caring Solutions
1. bundle needs as much as possible so there are fewer calls on the call light. I know it's not always possible! If possible, build ADL routines so they're more anticipated/scheduled and more efficient.
2. let the staff know they're appreciated, with words and maybe snacks. Let managers know who is excellent.
3. escalate as needed if/when there are safety concerns
4. aim for non-profit care centers whenever possible
Well, that's a few thoughts to start the conversation.
Cheryl Kauffman, PT, BCPA
Seattle Patient Advocates
The Older Americans Act established the National Long-Term Care Ombudsman Program, staffed by both paid and volunteer advocates. Critically, they work for residents, not facilities. They can address individual resident concerns and pursue systemic facility issues. Complaints feed into state and national trend databases that can drive regulatory action.
As a former Texas ombudsman, I can tell you SNFs were prioritized in caseloads over assisted living, even though both are covered under the OAA. The program is lean, but strategic.
As a first step I recommend looking for the ombudsman contact information typically posted at the facility entrance. Introducing yourself creates a ready partnership for exactly the issues you're describing.
Understaffing explains resource constraints. It doesn't excuse poor care.
Renea Stasaski, BCPA
Sonoran Wayfinders
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