Texas nursing homes struggle with lack of funding

Nursing homes in Texas on average have to cover a gap of nearly $20 per day to take care of residents who pay with Medicaid. As a result, nursing home operators have said they often find it challenging to retain quality staff, pay for new equipment and keep facilities up-to-date.

A bill before the state Legislature this session sought to close the gap with the help of federal funding but was unable to pass out of the Texas Senate before the session ended May 29. House Bill 2766 would have brought an estimated $440 million into the state through a federal reinvestment program, which could have been distributed across the state’s 1,200 nursing homes, according to Rep. J.D. Sheffield, R-Gatesville, who filed the legislation.

Nursing homes struggle with lack of fundingHowever, the bill did not pass and now, nursing home officials are worried a crisis could be imminent.

“We are on razor-thin margins,” said Eddie Parades, vice president of government affairs with StoneGate Senior Living and a member of the Texas Health Care Association, which represents 500 nursing homes across the state. “Without a rate increase, there will no doubt be nursing home closings in Texas.”

Nursing homes will start closing in rural markets first, but the effects would eventually spill over into cities like Houston, Paredes said.

“Those [rural] families won’t have long-term care placement and access, so they’ll be diverted to hospitals in nearby cities, which will create a backup,” he said. “We’ll quickly see a crisis in long-term care services.”

About 85 percent of the 120,000 nursing home residents in Texas are on Medicaid. The most recent data collected by the American Health Care Association in 2014 show providers in Texas spend an average of $157.84 per day caring for Medicaid residents. About $138.37 of that was reimbursed by Medicaid coverage, resulting in a $19.47 gap.

The growth of the reimbursement gap as operating costs continue to rise has resulted in a steady struggle to maintain quality care, Paredes said. In 2015, The Kaiser Family Foundation ranked Texas nursing homes last out of all 50 states and the District of Columbia in terms of quality care compared to other states.

Of the state’s 1,220 nursing homes, 317 were found to have “serious deficiencies,” according to August 2016 data from the U.S. Centers for Medicare and Medicaid Services.

The biggest challenge relates to retaining staff, said Sarah Aho, an administrator with Grace Care Center of Katy. Grace Care Center has 98 total residents, including 40 Medicaid residents.

“Turnover is really high in skilled nursing facilities,” Aho said. “Nursing assistants will leave and go down the street for a job that pays 25 cents more. Most nursing assistants in my area actually work two full-time jobs. It affects quality of care because these people are working 16-hour days, which leads to burnout.”

Officials with the THCA said they are dedicated to continuing the fight to raise the Medicaid reimbursement rate in the next legislative session. Meanwhile, nursing home operators in the Katy area are doing what they can to stay afloat.

Aho said she has to be creative with managing expenses. Still, Aho said having 40 of her 98 residents on Medicaid could be worse; some facilities have 80-90 percent of the residents on Medicaid.

“I would just like to see more legislators look at these nursing homes and what their needs are,” she said. “We want to be sure we provide our elders the best possible care. If you can pay your staff a better salary, you can decrease turnover.”

By Shawn Arrajj
Shawn Arrajj serves as the editor of the Cy-Fair edition of Community Impact Newspaper where he covers the Cy-Fair and Jersey Village communities. He mainly writes about development, transportation and issues in Harris County.


A Cy-Fair ISD employee distributes meals via curbside pickup for district students during the summer. (Courtesy Cy-Fair ISD)
Community Impact now seeking feedback from parents, teachers regarding 2020-21 school year

Help us adequately cover local education by submitting feedback here:

Harris County Judge Lina Hidalgo spoke about the county's continuing response to COVID-19 and a new small-business coronavirus relief program at a July 13 press conference. (Screenshot via Harris County Office of Homeland Security and Emergency Management)
Harris County now accepting applications for $30M small-business assistance program

Harris County businesses with fewer than 30 employees may apply for funding through July 24.

credit card shopping
City of Fulshear to collect nearly $300K in July from May sales

State data shows Fulshear will collect $298,622.14 in sales tax revenue in July, a 31% increase compared to July 2019.

Coalition of African American Pastors
Coalition of African American Pastors opens office in Fulshear

CAAP is a national faith-based nonprofit that supports religious freedom, marriage and family.

The seven-day rolling average of deaths per day in Harris County has increased from 3.86 on July 8 to 8.29 on July 12. (Community Impact Staff)
Harris County coronavirus count: After three weeks of surging cases, death toll starts to rise

The seven-day rolling average of deaths per day in Harris County has increased from 3.86 on July 8 to 8.29 on July 12.

Texas Commissioner of Education Mike Morath announced in a June 30 State Board of Education meeting that students will be taking the STAAR in the 2020-21 school year. (Courtesy Pixabay)
Education organizations call for STAAR requirements to be waived another year

Gov. Greg Abbott waived the State of Texas Assessments of Academic Readiness, or STAAR, testing requirements in March of earlier this year in response to the coronavirus pandemic.

With a clinical background in internal, pulmonary and critical care medicine, Corry has been with BCM for 20 years. He now focuses primarily on inflammatory lung diseases, such as asthma and smoking-related chronic obstructive pulmonary diseases. (Graphic by Ronald Winters/Community Impact Newspaper)
Q&A: Baylor College of Medicine's Dr. David Corry discusses immunity, vaccine production amid COVID-19 pandemic

Rapid development and distribution of a vaccine worldwide and successful achievement of herd immunity will be key players in determining the lifespan of the COVID-19 pandemic, said Dr. David Corry, a professor of Medicine in the Immunology, Allergy and Rheumatology Section at Baylor College of Medicine.

hand sanitizer
Katy-area confirmed COVID-19 cases reach 3,327, per July 10 data

Katy-area confirmed COVID-19 cases have reached 3,327, per July 10 data.

The new partnership will provide on-site, same-day testing and results for assisted-living facility staff and their residents. (Courtesy Adobe Stock)
State announces partnership for increased COVID-19 testing for patients, staff at assisted-living facilities, nursing homes

These test sites will help the state work toward the goal of processing up to 100,000 tests in the first month.

Texas Medical Center reports only 4% uptick in ICU bed use despite continued COVID-19 case increases

Compared to 1,350 total intensive care units in use June 30, Texas Medical Center has seen only a slight uptick in occupancies since then, with 1,394 reported July 9.

When interest rates are low, homeowners may look to save money by refinancing, which means getting a new mortgage with a better term or interest rate to lower payments. (Source: Matt Frankel/Community Impact Newspaper)
Refinancing a home, police departments address protests: Popular news this week from Greater Houston

Read popular stories from the Greater Houston area on Community Impact Newspaper’s website.