Senior Texans are relying on us and how well we take care of them is affected by decisions made in Austin.

Near the end of their life, many Texans deplete their financial assets and for the first time they need help. Their need for help isn’t linked to whether they are Republicans or Democrats. They are schoolteachers, small-business owners, and community leaders who spent their lives building a future for us and our hometowns. They are veterans who defended our freedoms and the police and firefighters who kept us safe.

How we care for this special population is a statement about our values as a society and government. And how well we are able to take care of them is significantly affected by decisions made in Austin.

Two decades of Medicaid payment shortfalls is putting a strain on Texas nursing home care.

For the past 20 years the state’s Medicaid reimbursement rate has fallen short of the allowable costs of providing resident care, placing a strain on nursing homes’ ability to maintain and improve quality of care for residents. As a result, those elderly Texans counting on others for assistance feel the consequences.

Medicaid reimbursement is not only relied upon to provide direct medical care, but also to support nursing home costs such as payroll, staff benefits, resident programs and nutrition. The shortfall affects the ability to retain skilled staff, make building improvements, upgrade equipment and enhance resident programs.

According to 2014 Medicaid cost report data, more than 77 percent of Texas nursing homes reported allowable cost of care that exceeded the Medicaid reimbursement. Current Medicaid reimbursement rates in Texas average less than $6 per hour to care for seniors in Texas nursing facilities

One of the most critical effects of the underfunding is its impact on a nursing home’s ability to retain skilled staff.

Low wages and high stress lead nursing staff to seek more financially rewarding, less demanding jobs.

Texas nursing home regulations may be the toughest in the nation yet they receive among the lowest reimbursement rates in the country.

Texas nursing homes are perhaps the most scrutinized in the nation. The state’s three strikes law is the only one in the country. In 2015, over 17,000 regulatory visits occurred in skilled nursing or assisted living facilities in Texas.  And on any given day, staff may need to respond to up to 34 different local, state and federal agencies with authority over the home. That’s a lot of bosses to worry about for the $10.75 an hour average wage a Certified Nursing Assistance is paid.

Encouraging nursing homes to try harder isn’t going to reduce the strain created by two decades of reimbursement shortfalls. They are already trying harder.
There is a solution — one that doesn’t cost the state a penny.