Because everyone aspires to work in a skilled nursing facility right? I get it, and if you have read any of my other posts, you would know the last place I wanted to work was a SNF. However, in the current market after PDPM changes (NOT the COVID market), SNFs became a more popular setting for travel jobs. Also, SNFs are known to be higher paying in the permanent job market, so it is never a bad idea to look into PRN jobs in this setting to make some extra cash! Again, if you have read other posts of mine (because I have SUCH a strong following for a blog that is less than 6 months old… that is sarcastic), you would know that the ONLY job I had not gotten an offer on after an interview was a SNF. Why? The one downside of being a travel therapist is having to keep your phone on you at all times in case you do get a call. If you don’t answer, they can just as easily move on to the next applicant, so you don’t want to miss that call. When this job, called I had to quickly exit from a patient’s room, so I felt somewhat flustered. That being said, I was still ill prepared for the interview and did not sell myself. This article will give you some example questions to be prepared to answer as well as questions YOU should ask during the interview and take into consideration if this job makes you an offer. Yes there will be some COVID centered questions as well because WHO KNOWS when this stuff will go away.. No seriously, does anyone know?

• Questions to prepare for:
  • Do you have experience in this setting?
    • IF THE ANSWER IS NO: Start with something along the lines of “I don’t have experience working specifically within a skilled nursing facility setting, but I do have experience with the population often seen in these settings.” Because believe it or not, you do!
  • Populations you may have seen that are also seen in this setting
    • Geriatric (very general, but if you have experience with geriatric population MENTION THIS)
    • Stroke
    • Post-op (Now, SNFs used to get more joint replacement post-op patients. Company and facility type depend on if they see several orthopedic or not)
      • Joint Replacement
      • Cardiac Surgery (CABG, stent procedure, pacemaker placement, etc)
      • Other Orthopedic such as broken hip, pelvis, humerus, etc.
    • Broke bones (of any type)
    • Unsteadiness on feet/ balance deficits
      • You work on balance in every setting, and there are usually a lot of falls in the SNF setting as well as unsteady patients
    • Dementia: Specifically for OT and SLP who do SLUMS and the Allen’s Cognitive Disabilities model
    • Amputations
    • Gait training/ assistive device prescription
    • COPD
  • “Do you have experience with *insert whatever documentation system they use*?”
    • I have been in 4 different SNFs. For therapy documentation, they have all used CASAMBA. For other documentation (such as orders), they have used Point Click Care, and Matrix care.
    • If the answer is no (which there are literally a TON of documentation systems) then simply say no but you are happy to find an online tutorial (youtube offers a CASAMBA online tutorial).
  • Do your best to not just leave answers at “No”.
  • “What would you say your biggest strengths and weaknesses are”
    • I have been asked this in all but 1 interview. I can’t walk you through this one.
  • They may give you a scenario question, one of mine was “Say you have a patient participating in an exercises/activity and they are growing frustrated and not wanting to continue, or are not grasping how to properly do it, what do you do?
    • Here you can talk about changing tactile, verbal, visual cues as appropriate and if that doesn’t work, introducing a completely new exercises/activity, or just change activity without changing cues if this is something they have been trying for several minutes. And talk about circling back to it during another session.
  • Lastly, they may ask about what outcome measures/ special tests you like to use. Popular ones for SNF:
    • Tinetti balance assessment (also a gait assessment)
    • 6 minute walk test
    • Function in sitting Test (OT/PT)
    • SLUMs (OT/ SLP)
    • BERG balance assessment
    • Nine hole peg test (OT)
    • Physical Mobility Scale
    • Obviously, there are PLENTY more
• Questions YOU should ask:
  • What is your productivity requirement?
    • Don’t get me started on productivity. I plan to write a whole post on it. It is measured differently in every setting. Basically in the SNF it is a %. How much time are you spending with patients while clocked into the facility. The requirement CAN and SHOULD vary between therapists and therapy assistants (as therapy assistants do treatments only so they usually have a higher productivity requirement and therapists have evaluations, screens, progress notes, and updated plan of cares that take a longer time and you can not bill for that entire time).
    • Be skeptical/wary of a 95% productivity rate ESPECIALLY if you are a therapist. That is when they are basically expecting you to be clocked out to finish documenting, this is a very difficult quota to meet. Hell, 90% is hard to meet for a therapist, but that is more often required. The one I am at now requires 75-80% for therapists and that is way more achievable.
  • If the productivity rate is high, do they have laptops/tablets that you can take into the patient’s room to document during treatments sessions?
  • COVID RELATED: Has the productivity rate changed d/t covid as well as rules of taking laptops/tablets in and out of rooms?
  • Is a therapist expected to screen or evaluate a non-therapy patient every time they have a fall in the facility?
    • This is expected of us at my current facility
  • What is the average amount of hours a therapist works per week?
    • If you are a traveler and are offered the job, talk to your recruiter about guaranteed hours. There is a common misconception with guaranteed hours. Companies you sign with think this means how many hours you HAVE to work. It actually means IF the company you are contracted with falls short of giving you these hours, you will still be compensated for these hours through stipends but not hourly. So if your guaranteed hours are 38 and you only work 32hrs due to low census, you will still be compensated 38hrs worth for stipends and only 32hrs of hourly. So it wouldn’t be quite the same as if you did work the full 38hrs. Now if you take the day off for vacation, you are not compensated with stipend money. Clear as mud? Great.
    • I was misled in my Missouri job. That week she said she was trying to keep her travel therapist from overtime. I didn’t realize that they would actively try to keep me from hitting 40 hours. I would clock in on a friday and be told “Hey you are at 35 hours already, watch you time and don’t work past 1:00pm”… And my weekly hours were usually in the low 30s.
  • The Last few questions are all COVID related:
    • Do you have positive cases/ is there a covid unit?
      • If so, what is therapy’s role with the unit/positive cases?
    • Hazard pay?
      • As a traveler, you most likely won’t get hazard pay since you are already getting a higher rate than the rest of the staff. But ALWAYS ask your recruiter about getting hazard pay if the rest of the staff is
    • Do I have to routinely get tested for COVID?
    • What is the PPE situation? (am I given one mask a day to wear every day, do i have to share a gown with coworkers,etc)

I hope this gives you more insight to interviewing for a SNF position, as well as helps you land that job/assignment! Of course if you are looking for a permanent position, ask about benefits. As a traveler, you receive benefits through your travel company, and a PRN worker does not receive benefits. If you have any other questions about working in a SNF, please feel free to reach out to me! And stay safe out there y’all!

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