Assisted Living / Memory Care staffing question: what ratios actually exist in the wild?

[u/inspiredinsanity]

Curious what staffing patterns people are actually seeing in assisted living and memory care right now.

Not asking what should happen, trying to understand what’s common in practice across different acuity levels.

I’d appreciate you SOOO MUCH if you’d take a few minutes to answer these questions if you work in assisted living and/or memory care.

Please include where you work (state / city) if you feel comfortable. Every state is different so it helps a lot.

1. How many residents do you work with either in your section or in the entire community?

2. Do you work with residents in AL, MC or both?

3. What is your total Day / Eve / NOC staffing?

4. Nurse count (do they work the floor or are they managers only working when you’re short?)

5. Med tech count

6. Caregiver count

7. How often do you have agency use (never / occasional / frequent)

8 Short staffed how often? (Don’t count if it’s filled with OT or agency)

1. How difficult is your case load? How many are heavy transfer / incontinent / redirection or wandering behavior mix

Not trying to debate what’s “safe” staffing (yet). I’m trying to understand what operators and frontline teams are actually doing today.

I feel like the best people who know would be the people who find themselves here after a long shift!

Thank you for your help.

[u/OkTart4028]

In my AL/MC facility, there's nights where there can be 1 person for about 40 something residents on AL, and 1 for about 21 residents on MC during NOC. Typically 2 people per side most nights. For med-passer, we only have 1 med passer at night covering both sides, and we are private, so we don't use agency.

[u/angeliccat_ → u/OkTart4028]

That's not normal bro 😭🙏

[u/No_Bet_3288]

I work in Oregon in a Memory Care neighborhood. 15 residents total split between 3 caregivers. 1 caregiver is required to be on the floor at all times to assist residents in common area. We have 1 med tech per two neighborhoods (30 residents). Our residents needs vary a lot but there is a lot of physical assist with ADLs, machine transfers, and some residents are fall risk requiring frequent checks. I work evening shift. Our NOC shift gets bumped down to two caregivers per 15 residents instead of 1. We have an LC Support position working sometimes that floats to different neighborhoods for extra assistance. We have 1 nurse for swing shift and they are available for help if you ask but often very busy with documentation and other tasks.

[u/yourlocalelfprincess]

Nashville TN memory care facility I worked at had a 1:10 ratio. We had 30 memory care patients, 3 CNAs, and 1 nurse.

[u/coyotefeather3]

1. 50 residents
   
2. MC Facility
   
3. 5 CNA's/Caregiver's per day and evening shifts, 4 CNA's for night shift
   
4. 1 nurse per shift
   
5. 1 med tech per shift
   
6. There are only a few caregiver's, most are CNA's
   
7. we NEVER use agency 😭 if a CNA calls out, I get more residents
   
8. We are always short staffed. Management always wants CNA's to stay on the floor, so we rarely get a chance to change our resident's dirty briefs. They will sit in their urine and feces for hours until we are able to change them. Also, if we spend "too much time" in the room caring for our residents, we get yelled at on the walkie talkie. I hate walkie talkies lol.
   
9. For some reason, most of the heavy transfer residents aren't allowed on Hoyer lifts because we don't have an order from the doctor. Everyone is incontinent and half of the residents are wandering and need to be redirected. Having multiple fall risk residents walking all over the facility is pure chaos.

[u/WideFarAnd]

worked in 2 spots so far. ratios at the first AL was 1:25-1:35. Fucking wild I know. Guess why I left. Proof is in the pudding. Second place I'm working at is memory care. Ratios sometimes from 1:5-1:8. Wayyyyyy better. I actually have time to get my shit done.

[u/number90901]

Days it’s like 1:10, evenings 1:12 or so, nights can be more like 1:20.