Texas Health Care Briefing No. 6
An experienced nurse offers insight on how Texas can improve
Julie Sulik, RN-BC, CLNC, was a young nurse aide still in high school when she experienced her first state nursing home inspection survey.
Since then, Sulik has earned her license as a Registered Nurse and worked her way up to become vice president of clinical services for Southwest LTC Management Services, LLC (Southwest LTC), a Texas-based company that operates skilled nursing and assisted living facilities in Texas and Oklahoma.
Sulik has experienced hundreds, if not thousands, of state surveys. She drew from her experience on December 13 to testify before the House Human Services Committee about how the process can be improved in Texas.
Sulik’s recommendations included giving Health and Human Services Commission (HHSC) employees more discretion in how to investigate a self-reported complaint. HHSC staff would then be better able to utilize their scarce resources by having flexibility in investigative processes.
“Currently, the surveyors are required to travel to the facility to conduct an on-site visit,” Sulik said. “Data indicates that an average of only 14 percent of lower-level complaints and self-report incidents are substantiated.”
“The regulatory environment we are forced to operate under is often the reason many highly competent, compassionate nurses, as well as other health care professionals, leave our industry.”
Another suggestion from Sulik included streamlining the dual enforcement of state and federal rules by reducing administrative redundancies. When survey results are serious enough to warrant the declaration of “immediate jeopardy,” Sulik suggested that surveyors be required to remain on-site until steps are taken to fix the problem. Sulik also suggested the process could be strengthened by HHSC developing measurable criteria to evaluate the skills and competencies of regulatory staff on an ongoing basis.
Finally, Sulik said the state’s heavy-handed regulatory approach to nursing homes is helping to exacerbate a workforce crisis that threatens the stability of the entire industry.
“The long term care industry is one of the most highly regulated industries in our country,” she said. “The regulatory environment we are forced to operate under is often the reason many highly competent, compassionate nurses, as well as other health care professionals, leave our industry.”