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.


MOST RECENT

Houston City Hall in rainbow lighting
Greater Houston LGBT Chamber of Commerce celebrates five years of service

The organization is open to all and serves members throughout the Greater Houston area.

Fort Bend County residents will be notified via email, text message or phone call with information about their COVID-19 vaccine appointment. (Courtesy Pexels)
Fort Bend County announces new COVID-19 vaccination system

More Fort Bend County residents than before can now sign up and be placed on a waitlist for a COVID-19 vaccine, thanks to the county's new registration system.

Here are the latest coronavirus updates from Fort Bend County. (Community Impact staff)
Fort Bend County surpasses 50,000 coronavirus cases; testing slowed during winter storm

Fort Bend County Health & Human Services has recorded 1,512 new coronavirus cases since the Feb. 15 winter storm that resulted in days of freezing temperatures and widespread power outages.

The new Fort Bend Epicenter multipurpose facility could be used as a spot for trade shows and sporting events, could act as a large-scale shelter for county residents in an emergency and more. (Community Impact Newspaper staff)
Large multipurpose complex coming to Fort Bend County; Sugar Land to widen University Blvd. and more top Houston-area news

Read the top business and community news from the past week from the Houston area.

Hank's Crab Shack gets and sells several hundred pounds of crawfish daily, especially during the peak of crawfish season. (Morgan Theophil/Community Impact Newspaper)
New Orleans-style restaurant Hank's Crab Shack puts 'a lot of love into the food,' owner said

At Hank’s Crab Shack, it is not uncommon for natives of New Orleans to walk in skeptical and leave with their heads spinning and stomachs full, restaurant owner Akina Robinson said.

Snow covers I-45 in Houston during a winter storm that hit Texas the night of Feb. 14. (Shawn Arrajj/Community Impact Newspaper)
Legislators probe energy officials over power failures, lack of preparation heading into winter storm

The Texas Legislature held hearings Feb. 25 with energy companies including Oncor Electric Delivery and the Electric Reliability Council of Texas in response to last week’s historic winter storm, which left millions of Texans without electricity for days.

Keith Luechtefeld spoke with Community Impact Newspaper about some of the short-term and long-term repercussions of the storm as well as some of the reasons why so many homes saw burst pipes during the freezing weather. (Community Impact staff)
Q&A: Greater Houston Builders Association President Keith Luechtefeld discusses power, plumbing, frozen pipes after Winter Storm Uri

Keith Luechtefeld spoke with Community Impact Newspaper about some of the short-term and long-term repercussions of the storm as well as some of the reasons why so many homes saw burst pipes during the freezing weather.

After the Feb. 20 fire, the building was declared a total loss. (Courtesy Jason Carlisle)
Midway BBQ management looks to future after destructive fire

After the Feb. 20 fire, the building was declared a total loss.

Winter Storm Uri led to closures across the Greater Houston area during the third week of February. (Courtesy Metropolitan Transit Authority of Harris County)
‘It’s been a rough year for us’: Expert explains economic effects of winter storm, ongoing pandemic in Houston region

“It's been a rough year for us economically; it's been a rough year for us public health wise. It's just been a rough year for us psychologically—first the coronavirus and then the freeze," said Patrick Jankowski, senior vice president of research with the Greater Houston Partnership.

Katy city officials plan to rebuild the bridge over Cane Island Creek along the First Street extension for drainage purposes as part of a project to increase mobility in the area. (Morgan Theophil/Community Impact Newspaper)
Upcoming Katy transportation projects focus on increasing mobility to match continued growth

Katy city officials plan to rebuild the bridge over Cane Island Creek along the First Street extension for drainage purposes as part of a project to increase mobility in the area.