I work in the admissions department of a LTC/SNF. I have noticed that bordering the end of the Medicare waiver period and following the end of the Medicare waiver period that the admissions director has been more frequently accepting cases outside the facility’s scope of care, cases that cannot be properly cared for due to staffing shortages/failure to provide staff training to accommodate certain medical devices. My director does not come into work for more than an hour or two, but instead goes to local hospitals to meet with individuals referred to us by social workers.
However, my department has several doubts about the legitimacy of her hospital visits and suspect she has been using this time to network, have lunch, and see a case when it is absolutely necessary—most often when my department asks her to directly see a potential admission due to a complicated H&P or when a family wishes to speak to her directly.
My director’s failures in screening of these referalls has led to an increase in hospitalizations, falls, and needs for sitter services that are unable to be met due to staffing shortages. These issues coincide with empty promises she makes to families and residents often without consulting with medical staff, pharmacy, infection control, or even discharge planning. These promises include assuring their medications will be able to be dispensed as soon as they arrive, even though that is reliant moreso on our contract pharmacy’s abiltiies, or that they will recieve rooms that are unavailable to them upon arrival because my director has been banking on a discharge occurring or an individual agreeing to a room change.
What is worse is that while she continues to be negligent and reckless in her acceptances, much to the chagrin of the facility’s therapy, mds coordinators, and the entirety of the nursing staff, she has been spending fewer time in office, forcing the entirety of my department, as well as others, to attempt to clean up her messes. However, my director does not seem to be affected so long as she fills beds, even when presented with genuine concerns brought upon by other departments surrounding the negative health outcomes and risks she is bringing around. Her motivation for keeping the facility full has been leading into overall inefficiencies within my whole facility, even deaths, meanwhile she is rewarded with bonuses, as administration sees only the numbers and not the liabilities.
What can I even do in this situation? I am not just some disgruntled employee annoyed at increasing responsibilities at my job, I just feel as though laws are being broken and I can’t stand around and watch.
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