therapist

dietary aide

registered nurse

licensed practical nurse

housekeeper

Sierra Tucson

I worked at Sierra Tucson as direct service provider for 90 days. In that time, I never had an individual meeting with my supervisor. Ever. 

It was difficult to get guidance on some policies and procedures. When I would ask questions I would often get directed to shared drives that typically did not contain the information that was supposedly there. Asking co-workers about policies and procedures would yield differing answers. 

My direct pay (salary) was good after some negotiation. However, many of the benefits advertised had significant caveats you only learned about after the fact. For example, some positions come with a $2000.00 signing bonus. When you receive the terms in writing, those terms explain the bonus would be broken up into quarterly installments that are paid out over TWO YEARS. If you left the company for any reason prior to those full two years, you had to pay back every pro-rated penny of what you had received of the bonus. Bonuses are taxed at a high rate. You would have to pay back the original gross amount -- not the net amount received after taxes. You'd essentially have to go into your own pocket to reimburse the company. A "signing" bonus paid out over two years with the repayment clause they use isn't a signing bonus, it's a control tactic. 

There are other caveats to advertised benefits as well. The company 401K match is so minuscule as to be functionally non-existent. You're told the company will pay for job-related training, but that doesn't kick in until you've been there for at least 6 months. And on and on. 

HR will tell you when asked about those clauses that they don't want to pay out money to people who aren't going to stay long. I totally get that. And through those policies and those answers they admit to having an institutionalized employee retention and turnover problem. 

The company is pretty management top heavy.  Too many generals and not enough service providing foot soldiers, so to speak. That, along with the high turnover, shows up as the place seeming to be chronically understaffed.

It appeared the main goal of the facility was to keep the census full, no matter what; regardless of staffing, ability to provide adequate care, etc. I suspected the detox/intake unit was being used as an overbooking holding tank for residential beds. Some residents would be told they were to be directly admitted to residential and end up staying in detox/intake from anywhere from 48 hours up to six days until a residential bed was open because of what looked like overbooking according to some of the chart review I did.

The overall quality of treatment provided for a residential level of care was poor and inconsistent, compared to other agencies I have worked for. A significant proportion of the residents I worked with had gone up to 12 days into their 30 day stay NOT having met with their Primary Therapist, had any treatment planning done, or had any other individual appointments with providers after intake and psychiatric evaluation. They would spend most of their time "going to classes" (i.e., psychoeducation groups).

While I was at the facility, there was an increasing number of residents being admitted with higher acuity, including being at higher risk of suicide. There did not seem to be an appreciable increase in service delivery, service quality, or coordination of services to handle the increase in numbers of residents with high acuity.

Residents would often communicate having been told ("promised", using their word) through the admissions process that a certain type and frequency of service or services would be provided them. What was communicated to them would then not be provided. Definitions of what constituted some services (e.g., "trauma services") were periodically redefined, which came across as gaslighting to both residents and staff. 

When residents would voice dissatisfaction with their quality of care or lack of services they believed were promised, they were given a stock Hotel California-style message. They can check out anytime they want, but doing so would be "against medical advice" (potentially voiding insurance coverage for the stay if they were there on insurance) and they would not receive any of their medication at discharge.

Chart reviews of residents I worked with revealed a significant number of them either NOT having any treatment planning done, or what constituted treatment planning was nothing more than copy/pasted boilerplate text across different residents. Many treatment plans stated that residents had received services the residents themselves said they never received. 

Overall, I felt like a piece of meat that was there to help extract money from other pieces of meat (the residents). 

I would not recommend this job to my worst enemy. At first you’ll think it pays well but after you experience some time there, you will quickly learn it’s not even close to enough for dealing with it. The job itself is not so bad, It’s the life draining boss that makes your life miserable. You will be constantly questioned on your job and even if you follow everything to a point, they still manage to tell you you’re not doing your job. Super micromanagement to the point where they hide to watch you (literally), make you use fitbits and a phone to track you. Lord forbid if you don’t appear on their map too because that’s an automatic “you didn’t do your job”. Lots of picking after other shifts. No accountability. Lots of getting your attention called but never explained why. Their communication desperately needs improvement. No one seems to know what is right because every shift does it different. You do get to meet some amazing coworkers although. The treatment center itself can be okay, but you will notice right away the unfairness when it comes to self pay residents. Everybody knows (including them) they run the show and can get away with anything. Lots of over booking patients even though we don’t have rooms for them so they jam another bed in a room and call it a day. There is quite a few entitled patients too. They have a cafeteria so if you work days/afternoons you have to pay to eat there. That’s another thing where they want you to take your lunch but you’re so short staffed it’s hard to take an actual lunch. Starting there can be overwhelming because everyone expects you to learn everything quickly (they need you and training can ruin how things run) because they’re a drowning ship. Upper ups do not care for your safety, learned that one the hard way. Zero room for growth and will make it impossible for you to transfer to a different department. They’ve gone through the lengths of pulling the people that had already transferred to a different department back because we were short. Just no, stay away. The position is too much of a joke, they don’t do your 90 day review in person and forget your yearly review. Zero initiative for when you need something/assistance but they will crawl to you when they need people to pick up. They will approve your requested days off then pull the “I can’t find the paper” so that means it never happened. Always make sure to make a copy, because they will lose it. The stress, constant pushing you down, always short staffed, not being appreciated as a worker is not worth the $12-$13 they pay. You’re better off in a minimum wage job.

I would not recommend this job to my worst enemy. At first you’ll think it pays well but after you experience some time there, you will quickly learn it’s not even close to enough for dealing with it. The job itself is not so bad, It’s the life draining boss that makes your life miserable. You will be constantly questioned on your job and even if you follow everything to a point, they still manage to tell you you’re not doing your job. Super micromanagement to the point where they hide to watch you (literally), make you use fitbits and a phone to track you. Lord forbid if you don’t appear on their map too because that’s an automatic “you didn’t do your job”. Lots of picking after other shifts. No accountability. Lots of getting your attention called but never explained why. Their communication desperately needs improvement. No one seems to know what is right because every shift does it different. You do get to meet some amazing coworkers although. The treatment center itself can be okay, but you will notice right away the unfairness when it comes to self pay residents. Everybody knows (including them) they run the show and can get away with anything. Lots of over booking patients even though we don’t have rooms for them so they jam another bed in a room and call it a day. There is quite a few entitled patients too. They have a cafeteria so if you work days/afternoons you have to pay to eat there. That’s another thing where they want you to take your lunch but you’re so short staffed it’s hard to take an actual lunch. Starting there can be overwhelming because everyone expects you to learn everything quickly (they need you and training can ruin how things run) because they’re a drowning ship. Upper ups do not care for your safety, learned that one the hard way. Zero room for growth and will make it impossible for you to transfer to a different department. They’ve gone through the lengths of pulling the people that had already transferred to a different department back because we were short. Just no, stay away. The position is too much of a joke, they don’t do your 90 day review in person and forget your yearly review. Zero initiative for when you need something/assistance but they will crawl to you when they need people to pick up. They will approve your requested days off then pull the “I can’t find the paper” so that means it never happened. Always make sure to make a copy, because they will lose it. The stress, constant pushing you down, always short staffed, not being appreciated as a worker is not worth the $12-$13 they pay. You’re better off in a minimum wage job

There are things that as a former employee I believe were done so wrong. The health care plan is a joke. They offer Short and long term disability, but do not offer if you or a family member is ill. They also do not follow FMLA guideline's 
I do not think i would ever recommend a job like this to anyone. Also the clients are given free rain over the place. No cleaning their rooms, Not having to do chores, They are catered to 24/7 very unlike most Rehab places. Once the company changed hands in 1/2016  the place got worse. Every thing is done by hand. All paperwork,  weekly MARS ( med rec's ) charting and even emergeny paperwork. The only reason they have computers is to read the 300 emails sent on a weekly basis. None of the medication is put into a Pixsus machine to distribute. The medication is all pulled out of plastic bags. On night shift the night nurses are expected to do or continue what the day shift did not feel like doing. Night shift get's a rather large differential, So i believe the day shift purposely leaves things for the night shift. The night shift is also expected to pull all the next day meds out of the plastic bags and fill for the next day. All LPN's are expected to do everything to do what a RN does including assessment's and they are paid much less. They even allow LPN's to be charge nurse most time this happen's on the night shift.

I have learned important principles:
*Understanding of and sensitivity to our patients and their families;
**Appreciation and practical integrated application of the most current practices of psychotherapy, psycho-dynamic clinical care, and psycho-education;
***Engagement and cooperation with the persons and organizations working together for the benefit of our patients;
****Commitment to promote and improve the mental well-being of our community.


I have learned to have a vision which is demonstrated through my :
*Understanding of and sensitivity to our patients and their families
**Appreciation and integrated application of the most current, evidence-based practices of psychotherapy, psychodynamic clinical care, and psycho educational.
***Engagement and cooperation with the people and organizations who work together for the benefit of the patients we serve.

As at team work, we strive in all that we do to make the facilities within our treatment network stand out from others through the delivery of compassionate, clinically excellent care that places the needs of others above all else.


Positive Aspects:

	•	12-13 hour shifts x3 for full-time (5:30 am - 6 pm) provide excellent work/life balance.
	•	Staff demonstrates genuine care for residents.
	•	Exceptional providers foster open communication, creating a safe and encouraging environment for learning and asking questions.

Challenges:

	•	Support staff is understaffed, leading to additional duties falling on nursing.
	•	Ineffective and harmful EMR system; can only open one patient’s chart, causing significant delays during a 15-minute med pass approx 11min waiting to scan meds and if pt has a question during med pass they have to wait until you complete due to only one chart section allowed to open at a time. No way to reference length, progress notes, etc in another tab or window at the same time. 
	•	communication with nursing is approximately 3000 emails a day, hindering effective nursing communication.
	•	Management adds additional tasks (approx. 2+ every week).
	•	Adapting to changing rules for patients can be challenging due to consistence with boundaries between nursing and support staff.

There are many extremely talented clinicians working there. Primary therapists do an impossible amount of work but are cut off of support from cliquish management.  It felt a little like high school again with the popular kids running the show. My immediate supervisor simply did not show up for meetings with me.  Marketing and intake personnel are either misinformed or outright dishonest - I’m not sure which.  Clients may expect to receive certain types of therapy but have to complain strenuously to get their expectations met. Clients put down huge amounts of money and are lead to believe their insurance will come through. It often doesn’t, and clients have to make this shocking discovery and make hard financial decisions in the middle of their treatment stay.  Clients’ schedules are padded with activities and poorly planned, repetitive psych-ed groups that leave them frustrated and without enough personal time to reflect and heal. It appears that Sierra Tucson has outgrown itself in the name of money and cannot sustain itself in this town with enough staff or competent, qualified management. 

This place used to be a great place to work when it was privately owned. Now that is owned by a corporation, they postponed my raise even though I performed well and received a perfect annual review by my supervisor. The managers are great therapists that became mediocre supervisors and tend to minimize incidents and fail to investigate problems related to clients and staff. Only a few people get to move up and get better opportunities within the company. They are always short staffed and asking you to do more programming without hiring extra staff to replace the ones that left due to stress or were fired to cut their costs. Ask people that work there and they will tell you the place is getting worse and worse, but the majority stay because they need the pay check. Coworkers were great, from the kitchen staff to therapists...just avoid interacting with management. They will get you fired for reporting problems or pressuring people to do the right thing. They like to pretend that things are great when they are not. Toxic work culture.

I enjoyed working with the other clinicians but the organization does not do what they say they do. The environment overall was not healthy and did not provide work/life balance. Management was not supportive and they have no concept of culture or being cultural sensitive to other ethnic groups. This is not a place for people of different ethnic backgrounds to work. It is not culturally safe. The pay is okay but you have to do a lot of things that are not described when you first apply. Some amazing therapist work there but they are not able to just do therapy with clients and the way the organization is laid out they know they need to hire case managers not have therapist doing both therapy for 1 hour a week with clients and group therapy and case management and continuing care. The upper management does not care about the work the therapist do, it's all about numbers. I am a good therapist and found it very hard to work in this environment and did not feel support even though management would ask what support I needed and I told them, they never provided it. I asked for more training and they said they would give me some and never did after asking multiple times.

This was one of the most toxic places I have ever worked. I worked hard and liked what I did, but you couldn't trust anyone you worked with. Everyone talked bad about each other. It was awful. I can't speak for how it is now; they have completely changed it. The patients, depending on the lodge you worked in, were unique to work with and I learned a lot about recovery and substance abuse. I met a lot of wonderful people and heard their stories. I learned about trauma and EMDR. It was a great place for that. I was there for 2 years on nights so I was able to review charts and learn a lot. I met many talented people and I loved to hear them play their music and sing; I loved seeing their art. Their stories often got to me. I will never regret working for ST because it was a wonderful learning experience for me and I met so many beautiful souls. I only wish my experience wasn't tainted by such toxic individuals working there.

Top Job Titles	Average Salary
Therapist 3 salaries reported	$26.00 per hour
Dietary aide 6 salaries reported	$15.17 per hour
Registered nurse 4 salaries reported	$45.20 per hour
Licensed practical nurse 4 salaries reported	$29.00 per hour
Housekeeper 4 salaries reported	$15.00 per hour

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