Texas Health Care Briefing No. 1
Dedicated caregivers fleeing underfunded Texas nursing homes
Turnover rate one of highest in the nation, Medicaid reimbursement one of lowest
Dedicated caregivers are fleeing low-pay, high-stress jobs in Texas nursing homes at record rates, a long-term care expert told members of a House Appropriations subcommittee in March.
The Lone Star State is home to one of the lowest care payments for medically dependent seniors, and has the toughest regulatory system in the nation for nursing homes.
“Registered nurses in Texas nursing homes have a 94 percent annual turnover rate,” said Scot Kibbe, director of government relations for the Texas Health Care Association. “These are the folks who take care of most of our parents or grandparents, or even most of us, eventually.”
Kibbe warned lawmakers of a brewing crisis as nursing homes provide more medically extensive care to a more challenging patient mix and cope with the additional administrative burdens of moving to a managed care model as required by the state.
“Nursing homes in Texas struggle to keep dedicated, caring staff because Texas has the third-lowest Medicaid reimbursement rate in the nation,” Kibbe said. “They are not just leaving their jobs, they are leaving the industry for better pay working at a fast food restaurant.”
Most Texans — more than 85 percent — in a Texas nursing home depend on Medicaid and Medicare. But by the state’s own estimates, the costs of taking care of these residents are more than the state reimburses the homes. And that gap continues to widen.
The result is low pay for the nurses and nursing assistants who are the very heart of long-term care. Top-notch nurses are leaving the industry in record numbers for higher-paying jobs with less stress every day.
“Working at a nursing home isn’t for everyone, but those who choose this vocation are some of the most caring people you will ever meet,” Kibbe said. “They are dedicated to making sure vulnerable and elderly Texans live with dignity, but we are not making it easy for them.”
And as Texas nursing home owners struggle to find and keep dedicated caregivers, the state’s over-65 population is set to triple. Kibbe encouraged lawmakers to do all they could to close the Medicaid funding shortfall. He also suggested creating financial incentives for nursing homes that provide high-quality care and investing more to educate a larger workforce.
“I think most Texans would agree we have an obligation here,” Kibbe said. “These are our parents and grandparents who have taken care of us and who now depend on us. Let’s make sure they are getting the care they deserve.”
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