The workers for the most part are great. The problem is they are understaffed and these businesses main concern is the bottom line. It might be different where you are at but not here.
Re your seconds point, there is definitely the possibly and room to understaff as for the most part there is no real regulation as to staffing numbers requirements (mainly because each facility had different types of residents with different needs), just that it 'is addiqualy staffed' which is open to interpretation. But starting this past July, we are required to report staffing monthly. While officially it's just for CMS to look at our numbers and staffing patterns, everybody knows that they will soon use that data and put in regulation for mandatory staffing levels (which if done properly, I think is a great thing). Furthermore, CMS now include staffing levels as one of the things calculated when rating facilities so if u go to nursinghomecompare.com u could actually see how many stars any given facility gets for staffing (although it doesn't give a full picture because a facility could have 4 or 5 stars for staffing g but that's only because the have a lot of vent, TBI, or other complicated residents).
Regarding ur first point, go back to how the operation is run. I've had the pleasure of working under 3 different admins in the same facility with 3 completely management styles so I saw how the top level management (as with probably any business) could make all the difference. But do realize that many of the people working there (at least in NYC where we have union shops) get paid less than they would if they were flipping burgers and the work is MUCH harder. So really the only reason theyre changing old people's diapers is because at some point they wanted to make a difference in the old sick population. Could be they turned sour, life got difficult, or they have a bad supervisor/department head. But that's not an excuse and if the working environment is good, with good support, ongoing training, properly staffed facility , then it's very easy to see quickly which ones are the sour ones (which any business with 320 or more employees is bound to have) and get rid of them.
I will tell you that there are a few 'big time owners' local that I wouldn't even consider working for even though they're offering way more $$. This is because they either have a name for being stingy with staffing or only care about the bottom line. I work for a small mom and pop company, where many employees have been there for 30-45 years, I hear stories how the owner has paid employee rent or car while they were going through difficult time, gives genurous gifts for things like weddings, baby's etc. and so on.
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