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Imperial Manor budget squeezed PDF Print E-mail

By Jan Schultz
The Imperial Republican

It’s not an uncommon problem in communities that operate a nursing home.
Imperial Manor administration continues to battle a national shortage of skilled nursing care, having to turn to “Agency” nurses from outside the community.
When facilities such as the Manor and some hospitals face shortages of nursing staff, they can turn to outside firms such as the Ford Agency the Manor uses based in Chappell.
At the present time, Manor Administrator Kathy Andersen said they are getting RNs, LPNs and  Certified Nurse Assistants (CNAs) from the Ford Agency.
But, it’s costly. Andersen said, generally, an “Agency” medical professional will run about $20 more per hour in pay compared to their on-staff employees.
In addition, the Manor pays mileage to the “Agency” help, which can come from as far away as Denver. The Manor is also using Agency staff from McCook, North Platte and Hemingford in northwest Nebraska.
This past year, the Manor paid out about $180,000 for Agency pay and mileage, with an increase to $270,600 for those costs budgeted in the 2009-10 fiscal year.
The mileage alone can run $5,000 a month, and Andersen doesn’t see much light at the end of the tunnel either.
“From the looks of it now, we may go over” the money budgeted for 2009-10, she said.
The core of the problem remains the nationwide shortage of nurses, Andersen said, and it’s an especially big problem for all nursing homes that have special requirements in the care of their residents.
Andersen noted that some of those requirements include:
— The Director of Nursing (DON) must be in the building eight hours a day, Monday through Friday.
— In addition, for the 6 a.m. to 2 p.m. shift, there must be two other licensed medical staff (RN or LPN) who can administer meds.
— The 2 to 10 p.m. shift must also have two licensed medical staff on duty who can give meds.
— The 10 p.m. to 6 a.m. shift must have at least one licensed person who can give meds.
— In addition, a minimum of four CNAs must be on duty for each of the 6 a.m. to 2 p.m. and 2 to 10 p.m. shifts, with at least two CNAs on from 10 a.m. to 6 a.m.
The staffing requirements vary based on the number of residents in the home, but if the number surpasses 32, Andersen said an additional CNA is needed on each of the three shifts.
That’s all in addition to other specialized medical staff, including a restorative aide three days a week to ensure residents are getting physical activity and walking if they can, and an LPN for about 32 hours a week who completes the required assessments for Medicare and Medicaid reimbursement.
Another new requirement for nursing homes that came down the pike the past year is infection control. That means two full days of time from an RN or LPN who implements an infection control program in the Manor.
Right now, Andersen said the Manor’s biggest need is for CNAs.
They are using anywhere from four to six Agency CNAs every day, along with one to two LPNs daily. Right now, an Agency RN is used every other weekend while one of their on-staff RNs recovers from surgery.
CNAs must go through a 72-hour class to become certified.
Oftentimes what happens, though, once that person is certified, they’ll find work closer to home or decide to stay home with young children, Andersen said.
But, Andersen isn’t giving up. She said they will hold another CNA certification class here if there is interest.
She said there now are a couple of high school girls that work some evenings and weekends as CNAs.
“It’s a great job for boys, too,” she added.
The after school 4 to 9 p.m. time slot is a time when they can use CNA help, she noted.
If the Manor could get more RNs, LPNs and CNAs hired as fulltime employees, it will benefit everybody, especially the residents.
“Continuity of care is important, and it is better for the residents,” Andersen said.    
Someone there each day will also notice the little changes in the residents that could be vital to their care, she added.    
Andersen feels if they were fully staffed with nursing professionals, it could save about $75,000 a year.
And, if that happens, they could also pay the local employees more per hour, she said.
Andersen and Roger Petrick, vice president of Rural Health Development which manages Imperial’s senior care facilities, told the mayor and council last month that they are going to expand advertisements for nurses to a wider area, including several Midwest states.
“With some of the unemployment in other areas, we’ll see what we get,” Andersen said.
She also joked that the council, should pass an ordinance that any new people moving to town have to come with a spouse who’s a nurse, LPN or CNA.


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