85th LEGISLATIVE AGENDA
> Supplement nursing home reimbursements without state funding through the Nursing Facility Reinvestment Allowance
Almost 80 percent of nursing homes in Texas are not having their costs covered for taking care of Medicaid patients. The continued Medicaid reimbursement shortfall is having an effect on the quality of long-term care in Texas by constraining wages for critical caregivers, preventing nursing home owners from buying much-needed medical equipment, updating aging facilities, and limiting nursing homes’ ability to invest in resident programs. All of this affects a facility’s ability to improve resident quality of life and encourage resident independence with daily living activities, so important to an individual’s well-being. Without a substantial increase in the state’s Medicaid reimbursement rate, alternative funding options must be provided to improve the quality of nursing home care and avoid a collapse of the state’s long-term care safety net.
> Provide stability to the state’s long term care industry by managing Medicaid bed capacity
Texas has an oversupply of Medicaid nursing home beds and a 70 percent Medicaid bed occupancy rate as a result of years of overbuilding without the regard for need. The state’s weak Medicaid bed moratorium also allows numerous exceptions and waivers, resulting in little or no control to regulate the growth in number of Medicaid beds available. When a nursing facility cannot fill its beds, fixed costs must be met through higher charges for the beds that are used. Underutilized facilities are not able to improve their infrastructure and invest in their staff, increased stress on understaffed caregivers contributes to high turnover, and high turnover results in a lower quality of care and increased rehospitalizations. Too many nursing facility beds creates a strain on an industry already struggling to attract and retain skilled caregivers.
>Let Texans – not actuaries – choose their caregivers. Maintain freedom of choice
In September 2017, A managed care organization may refuse to contract with a nursing facility provider. This would be disruptive for residents—who may have to leave behind beloved friends and trusted staff members—and families who find they must now travel farther to visit their loved ones. Managed care organizations’ efforts to narrow their hospital and doctors’ networks can be inconvenient, forcing people to find new doctors. But narrowing the networks for nursing homes can mean displacing the most vulnerable Texans from their homes and their families.
> Defend SB 7 Protections
Senate Bill 7 (83R) contained several protections for skilled nursing facilities and their patients with the implementation of managed care in 2015. Other important provisions have been agreed to between DADS and stakeholders. Preserving these protections is vital to ensure that managed care works well in Texas’ long-term care system.
> Preserve Tort Reform Protection
Patients and providers have benefited from reforms in Texas tort laws that were approved by voters in 2003. These reforms should remain in place.