The nation’s largest assisted-living chain uses a staffing algorithm; some managers say they quit or were fired after they complained it left facilities dangerously short-handedTwo decades ago, a group of senior-housing executives came up with a way to raise revenue and reduce costs at assisted-living homes. Using stopwatches, they timed caregivers performing various tasks, from making beds to changing soiled briefs, and fed the information into a program they began using to determine staffing.
While assisted-living chains promote their properties like all-inclusive resorts with round-the-clock care, many However, when the company began rolling the algorithm out to all its facilities, in 2013, then-CEO Andrew Smith told financial analysts one of the main goals was “to make sure that we don’t over-staff."
“I don’t blame a lot of the people who work there,” said Jane Millan, 72, Walker’s daughter, whose wrongful-death lawsuit against Brookdale is set for trial in May. “They don’t have enough staff to do the duties they have to do, so something has got to slide.” An expert hired by Brookdale said in a court filing that the North Carolina analysis failed to account for employees who clock in under one department, such as a cook, but then contributed to caregiving tasks when they had extra time.
responses to the lawmakers’ questions but the committee has declined to make them public. A spokesperson for Atria said the company prioritizes the safety and well-being of residents. In interviews, McNeal and nine other former executive directors of Brookdale facilities said Service Alignment failed to capture the complexities of working with seniors with cognitive decline. For instance, helping dementia patients take showers may take two or three times as long as other residents, because they often refuse to get undressed in front of caregivers they may not remember and need to be patiently guided through the process.
Some managers told their bosses that Service Alignment assumptions must be wrong and asked for exceptions — which they sometimes got. Brookdale’s solution to the wide variation in resident conditions was to charge more when they needed more time for any task than Service Alignment allotted.
As managers struggled under the new staffing system, the company’s finances got worse. More than three-quarters of Americans 50 and older want to remain in their homes for the long term, according to a 2021by AARP — a number that has remained constant for more than a decade despite the industry’s marketing efforts and the aging of the nation’s demographics. Until recently, that trend left Brookdale and other industry leaders with too many buildings and not enough residents.
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