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New Hire Series: Getting a Job in a SNF

Posted by Mandi Wilhelm, MA CCC-SLP on

There's so much to think about when starting a new job and the hiring process. I'm especially thinking back to when I was looking for my first job out of grad school. I wish at that time I could've found a list of questions to ask, or things to be thinking of in the interview/hiring/new job process. It can be overwhelming to feel like you're suddenly expected to know what you want from an employer, and to know what they want from you. Most employers will let you know via a handbook and orientation process what their expectations are, but here are some things to be thinking of as you get started in a new job at a SNF (skilled nursing facility). 

Before You Are Hired

  •  Ensure you will have a thorough orientation and learning period. With a CF this seems compulsory, but believe it or not, all mentorship situations are not built the same. Make sure you know who you will be contacting when you need questions answered, how much supervision you will be getting, and whether there's room for observation during your orientation period (you want observation, both of the person you're working with and then switching roles for them to observe you). 
  • What is the patient population like in the particular building, how many long term beds (patients who will be staying there indefinitely) vs short term beds (meant for rehab only, these rooms turn over fairly quickly as people stay until they are done healing and then leave). What is the average length of stay? Is there a specialized unit for dementia care?
  • Ask about company structure. Is this a contract company you'll be working for, or will you work for the SNF themselves (which would be called "in-house therapy")? If you are proceeding with a contract company, familiarize yourself with other buildings they work in, and whether you'd be expected to travel for low census days and how they handle high census (do they have PRN or on-call staff they can pull-in to help).  
  • Make sure you know what kind of pay and benefits are competitive in your area, and what the productivity requirements are for the company. (You may even ask how many staff meet productivity, what happens if you can not obtain the productivity standard?) 
  • What are the company's values? Before an interview, it's important to read up on a prospective employer to know something about them in the interview process and to determine if you'd be a good fit in their organization. It's also good to bring any of your questions related to their business to the interview. (Are they planning on growing more in the area, are they having a good year, etc?)
  • Ask about which materials are available. How available are instrumental assessments (and are staff receptive if you advocate for changes in textures or feeding strategies)? **Sidenote: materials and instrumentals should not make or break your decision but you should know you will have an uphill battle ahead of you advocating for patient care if you can not readily access these things initially. Don't let this scare you away, but it's something to be aware of and to familiarize yourself with the options for instrumental assessment (local mobile options, local hospitals) that you can partner with to improve the care for your patient population (if you see patients with dysphagia)

When You Start

  • Learn the names and duties of DON (Director of Nursing), ADON (assistant director of nursing), MDS nurse, kitchen manager, dietitian, physician, nurse managers, housekeeping managers, maintenance staff, staff nurses and nursing aides, as well as rehab staff.
  • Learn the layout of the building, all codes for entering and exiting locked doors, emergency procedures (fire, weather warnings, etc.)
  • Develop an understanding for which materials and tests are used commonly by the staff, and familiarize yourself with these items.
  • Ask around about the dynamics of the building, get a feel for the general workflow and rules. For instance,
    • Is it acceptable to wake a resident for treatment?
    • Can a resident be removed from an activities event?
    • Can documentation be completed in the dining room?
    • Can patients be treated in the dining room?
  • Ask the director of rehab or rehab manager to review billing guidelines as well as reimbursement information with you. A basic understanding of the business will help you in the long run.
  • Get in the habit of praising others. Positive feedback wins people over. More important than being liked, you want to be valued and respected so your input is well-received to best serve your patients.
  • Ask about any affiliations, hospitals or physicians that refer frequently to the SNF. It will be helpful to know what the surrounding community and physicians value. (For instance, if many patients attend religious mass in the afternoon, you will want to know this to respectfully schedule around this commitment). 

Although not exhaustive, I hope this gives you a general outline for your interview questions and the new hire process. Download our free SNF interview form here.  

Wishing you all the best with your job search and interview process, and the start of your career as a SNF SLP!