nursing assistant

registered nurse

licensed practical nurse

nursing supervisor

nurse's aide

Genesis HealthCare

A typical work day for a manager is to complete and review all schedules. Once this piece is mastered, it typically takes between an 45m to an hour to complete so not entirely daunting of a task once you get to know the system and insurance rules and regulations. Following that your day is filled with a lot of problem solving between your therapists schedules with patient issues/appointment issues or following up with other unit managers/social work in regards to patients progress towards their discharge or concerns the patient may have about their stay. This job definitely requires you to be able to multi-task and be able to conform to the situation you are in at that moment. You may have to be writing a therapist up for disciplinary action in one moment then speaking with a family member of a patient that has a poor prognosis the next moment. You also have to be extremely detailed orientated as well to ensure that your therapists are following the correct billing practices, ensure that they are in compliance with all standards for the state, their license, and medicare. We always strive to be customer focused as our saying goes "your therapy, your way" so we strive to ensure the customer is always satisfied with their care. 

I have learned a great deal working at Genesis Rehab Services. I started at an entry level position. So i have learned the ins and outs of how management works with both the HR side of it as well as the financial aspect of it. 

The workplace culture will depend on which facility you work in and how that specific team is. I have worked in many different sites and my first goal when taking over as DOR is to ensure that the nursing and rehab team work together rather than separately. The patients will not get the care they need if we are not working together so that is why i always have a focus on a team center approach. 

The hardest part of this job is the work and life balance. Often times you may seem as though you're working 40h per week in the facility, but often have to leave work to go home to finish up reports, documentation, billing, check projections, etc. Often times, you have to work from home on the weekends when you have a therapist working to ensure schedules are set, projections are accurate and that the therapists are meeting their targeted productivity for that day, often on both days during the weekend. Other things that can be difficult with managing work/life balance are often times you will have to deal with PRN therapists while you are on vacation to ensure they're confirmed for working or dealing with scheduling/daily issues for them. 

The best part of this job is the ability to grow therapists into their skill set. You have the ability to help them become a senior therapist, manager, clinical specialist etc. The other great part about this job is to see the patient progression across the continuum. We often see patients in our centers and then move onto seeing them in their homes in an outpatient setting. This is one of the most awarding parts of this job.

If you are a healthcare professional who believes in honesty, respect for others, and doing what is right and ethical for your patients. Then Genesis is not the place for you. Especially Oakhurst in Ocala. Oh boy where do I start? I guess at the top with management. I have worked for my share of companies. And to say the least all of the management staff there at Oakhurst is very disorganized and careless and it shows. I had one fifteen minute interview with a unit manager and I was taken back to HR for new hire paperwork, my drug test and all the other new hire requirements. Now anyone who has ever been employed or that has had a loved one at this facility can tell you they are ALWAYS short. Yet it took them over a month to call me back with a date for orientation. Even after calling for weeks and asking to speak with someone from HR, a unit manager, and the DON. And their excuse was that the former HR manager had transferred(as if there is only one person in that WHOLE building who can take care of bringing in new employees). My point is, that the management staff is very lazy. There is clearly no teamwork because everyone feels if it is not their job they shouldn't have to do it or be concerned with it. The nurses are the same way. The CNAs try to tell them something about their patient. And they will get very rude and terse with you. I had one nurse that just flat out rolled her eyes and walk away from me while I was in the middle of telling her that our RESIDENT needed something that I clearly couldn't help with. I was so furious that I went on to tell the weekend supervisor and he went on to say that she is a good nurse and he was "surprised". Then when they don't do anything about it. Or if something happens like someone falls or has to get sent out to the hospital. Or they call their family and explain how they havnt got helped and they come up to the facility furious.  Everyone is upset with the CNA and they don't care because their not the ones that have to answer the light and be fussed at. And they know that.  Nurses as well as management are good at avoiding issues until something happens. Like when state gets called(which they pretty much live at this facility) or AHCA has to investigate them. If you are a healthcare professional, and you want to keep your license, certification or what have you. I suggest staying  far away from this place!

This job has taught me a lot. I have been able to expand on the knowledge gained from nursing school and with the diversity of all the patients that come through this facility you are never at a loss for practicing a different skill whether it be wound care, staple removal, catheters, tracheostomies, NG tubes, wound vacs, dialysis, immunization, medication administration, vitals, or assessments. The staff there are not always willing to help and this provided for an difficult work environment at times. The nurse to patient ratio was overwhelming on a good day. This in turn is not entirely the companies fault but the state of Idaho deems this as appropriate. Staff would call in on a regular basis and you would be expected to pick up their shift. There were few times that management would come in and work those shifts when there was no one else able to cover. I have experienced 16-20 hours shifts with only 5-6 hours off before coming back in for another shift because of this. I have always dealt in geriatrics and these people have so much to offer and teach us but with the work load and expectations placed on you as the floor nurse you don't always have the opportunities you would like to be able to interact and communicate with them. On the rare occasion that I was able to sit in a room and interact with a patient was one of my favorite aspects of the job, then on the other end of the spectrum is losing a patient or having to watch them and their families experience end of life or hospice. We had great hospice connections and patients were comfortable and families were aware of what was going on. Overall I feel that I have learned valuable skills and abilities from some great nurses who were willing to take that time to teach. I will always be able to take that with me and apply it in the future. Once management gets settled after several position changes I hope that this facility can go back to its former glory and be somewhere I would recommend a friend or new nurse. Be prepared for stressful situation and being able to think quickly on your feet with little to no help at times depending on the shift your working.

At my last employment I was a bookkeeper for a health care facility. A typical day at work consists of maintaining the buildings census. I would check to see if any new patients were admitted and met with them to make sure they had a way of paying for their stay in the facility. Whether it be paying out of pocket, health insurance, or the need to apply for medical assistance. I would obtain all financial information; bank statements, deeds, or any assets that they own to see if they are eligible for assistance. Call families to collect payments, cash, money order or check. I would follow up with them each week along with the continuing new patients each day. I would work with other coworkers as a team and split the number of patients coming in by month. For example every other month would be assigned to a specialist and continue to work with old patients already assigned as well. The hardest part of the day was the initial conversation with the patients about money. No one likes to talk about money during the time of pain, grief, or during hard times, I just explain to them that I am here to help them make their stay comfortable. This can also be the most enjoyable part of the job as well. I am a people person and enjoy meeting new people. You can learn a lot from someone else no matter the situation. I met with a lot of elderly people with great stories and also taught them a lot of things about health care and medical assistance. Normally when you speak to someone about medical assistance the initial thought is that all of their assets will be taken away and that they could lose their homes. So informing them and keeping them at ease is always good. Along with bookkeeping and medical assistance over the years I have gained experience with correspondences, data entry, and administrative work. These tasks had very high demanding deadlines and I communicated with other agencies. I am also able to work on my own without supervision. I am very flexible and can work with or without people, what ever is given to me I am confident that I can handle.

I enjoyed my time at Genesis Corporation. I was on a busy rehabilitation unit on the 3-11 shift. I have cared for up to 18 residents. During the 3-11 shift, it was typical to have admissions come during this time. I have successfully completed the admissions and taken care of my daily duties of administration of medications, treatment care, and the ongoing needs of the other residents. I was very familiar with the admission process from paperwork, physical assessment, and completion of process though the computer system. 
I learned that every day is different. Most importantly it was imperative for me to be totally present during my time at the facility. I would do rounds daily prior to starting any other work that needed to be done. I have found though my experience that if I did not know what the baseline of the residents status by visualization, I could miss an important element when I saw resident on my medication pass. Management of the facility, like in life, had it's ups and downs. There was a period of time when we were without a DNS and the ADNS was in charge. The ADNS did an excellent job during this time assuming her own duties as well as acting DNS. My immediate supervisors on the 3-11 shift changed 4 times. I became resourceful while they learned the aspects of their new duties. My experience with co-workers is that some are very helpful and others are not as helpful. I always tried to be there for co-workers even if it wasn't immediate. (Except in an urgent situation). 
The hardest part of my job was, because resources were not available on the off shift, family members would like to know specifics about their loved ones day. PT/OT used their own charting systems and there wasn't availability of some specific questions. I would try to resource by asking family to call or come in if they could to participate in daily therapies. 
The most enjoyable part of my job was to see the resident improve in their progress. I liked to see them smile and say, "I missed you yesterday". Very rewarding.

Area Directors and above tend to dictate what treating therapists will do.  There is no real collaboration, just constant directives to increase your productivity and efficiency to upwards 85-90% to accommodate constant promotion of new Vice Presidents or Senior Vice Presidents in various areas.  The company is top heavy and continually threatens to cut line staff standard hours and/or pay, yet they continue to get raises/bonuses.  Genesis does offer good PTO accrual, yet you have to apply 6-8 months in advance to use it; and even then you may have it rescinded as early as the day before your time off even after it's been approved.  The Area Director is exceptionally condescending and treats DORs as minions and line staff as just replaceable worker bees.  Its next to impossible to hire new staff, due to the fact that the current COAD has a poor reputation in the therapy community.
  
With PDPM starting, there have been multiple layoffs of staff with no consideration of seniority or job performance.  COAD literally reads off a script and when asked direct questions as to how the decision was made, only offers to set up a call with HR and you are asked to leave immediately with no "thank you for your patient care" or anything like that.  The company would rather terminate good employees that actually care for the patients, instead of getting rid of middle/upper management.

There have been no raises in the last 5 years, for line staff.  As a DOR you consistently work 50-55 hours and sometimes more, with no additional compensation or ability to flex off time.  When you do ask to flex time, you get told to take a few hours off during the week instead of a whole day and then you are still expected to put in over 40 hours and work the weekend.  Line staff standard hours are cut, if you work less than your standard hours for one week.  This allows them to pay you less PTO when/if you get the opportunity to take off.  Overall, this is not a good place to work and the work life balance they speak about is non existent.  The only reason I work here, is that they are the only game in town.

I started here as a new graduate nurse, which is great because they hire a lot of new grads and there are many facilities that require experience.  My co-workers are great and always willing to help out if you have a problem or need advice about a patient.  
However, after months of management promising me that I would get a different schedule and shift, it still has not happened.  Many other nurses work twelve hour shifts (which is what I requested), but "staffing 12 hour shifts is so difficult" according to management.
I used to pick up a lot of over time, sometimes 3-4 extra shifts a week, working many 16 hour shifts.  Management has no appreciation for staff working overtime or helping out in a crisis.  No bonuses are given for picking up time when they are desperate.  Now I pick up maybe two to three shifts extra shifts every two weeks.  Management does not care what shift you work, especially third shift, they will call you in the middle of the day while you are sleeping and then ask why you did not pick up the phone or why you did not call them back.  
Vacations are denied 80% of the time, due to not having enough staff.  Staffing is low because of management, and many nurses and CNA's are quitting because of it.  
I cannot stress enough how unprofessional management is.  When a current employee gives their notice, they make their life a living h*ll.  I've seen it happen quite a few times.  
Many times they take patients that staff is not able to handle, or the patients have very complex medical problems that require more attention than we can give them.  If we had less than 20 patients, it would be managable.  On the long term care units, there is many times one nurse to 40 patients.
Overall, I like my job because of my co-workers and because I enjoy helping people.  I have great experience because of working here and have taken care of a wide variety of patients.  However, I have never been more stressed out or more sleep deprived in my life.  I am hoping to move on to a better company with much better management.

SunBridge/Sun Healthcare Group have poured a HUGE effort in providing detailed management information at your fingertips for use in daily management of services at SNFs.

I had the very best Regional Vice President and a few very caring and capable regional support staff. Kudos to Sun for using RDs so intensively in services.

There are numerous opportunities for advancement, and the company really tries hard to promote positive employee relations. They pay Administrators well in facilities that can really produce results under strong leadership.

Sun has lost the "edge" for a number of reasons related to much loss of inspiring leadership below the CEO, and the challenges with sustaining the very high cost of their huge infrastructure that they would not reduce/compromise in light of loss of Medicare reimbursement and mostly fixed or declining Medicaid rates. They simply had to be acquired, and the future might improve under Genesis leadership.

You can do a lot worse in the SNF for-profit corporations. A very capable Administrator and very talented Director of Nursing can still make a huge positive impact on consitency of care, and quality of life - the only real reasons to show up.

All in all, a tremendously valuable professional experience, although it can no longer be recommended for anyone who wants to balance work with a family life or any outside interests.

Typically I work ten hour days and arrive early to prepare the facility for treatment throughout the day. I must be available at 9:00am for the morning meeting amongst managers in the building to review updates in the community and of the residents of the facility. Between 9:00am and 3:30pm the majority of my time is spent doing a variety of things: transporting patients to their appointments, teaching exercise classes, contacting physicians and/or family members about the status of a patient, ordering equipment, receiving phone calls, training other employees, screening incoming residents for their need for therapy, and an abundance of other miscellaneous tasks. I spent the rest of the day mostly filing and preparing medical records for submission to Medicare and physician review as well as prepare the schedules for the six full time therapists on staff. My manager is very supportive however tends to pass a lot of her responsibilities off to me and this has continued to accumulate over the past six months. This leads to the hardest part of my job: the workload. I have continued to absorb more responsibility to the point where 50 hours a week is not enough time to complete my duties. This causes a large amount of stress and dissatisfaction with the workplace. I enjoy the patient interaction and the small impact I am able to have on the patients that we see. I love working with others and supplying my knowledge health and wellness to those in need. My co-workers are supportive and a pleasure to work with, however often tend to be overwhelmed with work and pass off a lot of duties to me as well.

I was recently terminated and let me tell you this was the worst facility I’ve ever worked at. They had bed bugs and tried to blame the employees for bringing them in. Scabies outbreaks all the time. Several nights we had to clean residents with pillow cases! YES pillow cases/bibs. There have been times when there weren’t any gloves, hand sanitizer and PADS. Crazy right??!! The management doesn’t know how to talk to their employees. They talk to you like you are absolutely NOTHING! I was there  3 years with NO RAISE. Several nights on graveyard shift the building was short-staffed and the Gna to Resident ratio was 1:33. I had been months without a lunch break. I’m sure many would ask “well why did you stay?” Well to answer that simply is to say FOR THE RESIDENTS! You come to love and cherish the people you care for. You don’t want to leave them because no one else seems to care and advocate for them. If you like to be the teacher pet and just think of it as just a job and a check you’ll do fine. But if you have a heart and are a compassionate human being with a conscience, you’ll never last. 

They don’t even make enough food to feed the residents in this facility. Patients order a roast beef dinner and the kitchen staff will say “sorry here’s a PBJ” I could write a dictionary sized book. I tried calling corporate but then you end up getting black-balled into some mess. Which is why I’m no longer there today. Better off working at McDonalds. You’ll make more and you’ll have a peace of mind at the end of the day. I could go on and on and on AGAIN! This place is bad for mental health and physical health. 

Blessed that God closed that door. I just hate that my residents have to suffer without me there to advocate for them.

Top Job Titles	Average Salary
Nursing assistant 2400 salaries reported	$20.52 per hour
Registered nurse 2129 salaries reported	$41.65 per hour
Licensed practical nurse 2247 salaries reported	$32.14 per hour
Nursing supervisor 651 salaries reported	$42.51 per hour
Nurse's aide 632 salaries reported	$16.32 per hour

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