Long term care providers across Texas continue to deal with COVID-19 and look for long term sustainability and viability.  It will be critical the this upcoming legislative session, we engage the Legislature to build support for a long term financial investment as well as policy changes to address the historic staffing shortages.  Our collective focus will be on three key areas:

> Address the Medicaid Funding Crisis

According to Texas Health and Human Services Commission Data, the gap between the average fully funded nursing facility Medicaid rate and the average paid Medicaid rate (based upon appropriations) is now over $123 per day (June 2022). Given that 2/3rds of Texas nursing home residents care is paid for through Medicaid, this gap impacts quality care, contributes to staffing issues and an inability to maintain modern facilities. Facilities have relied on increased funding from the Public Health Emergency (PHE) declaration and the temporary add-on funding for sustainability.  The last legislative appropriation to increase the Texas Nursing Home Medicaid Base Rate was in 2013.  With the PHE expected to expire in the coming months, we need the Legislature to take action in 2023 to fully fund LTC facilities beyond the PHE.

> Address the Historic and Ongoing Staffing Crisis

Decades of understaffing in the profession along with COVID-19 has caused facilities to have more and more difficulty finding and hiring staff.  We must address both current and future staffing shortages in long-term care facilities to ensure all aging Texans have access to quality care across the state. We need a multi-faceted approach to attracting staff to join long-term care that includes:

  • Expanding and incentivizing the availability of faculty in nursing schools through the state’s Nursing Faculty Loan Repayment Assistance Program.
  • Increasing the number of nursing school graduates through additional funding appropriated to the Nursing Shortage Reduction Program.
  • Establishing a long-term care nursing student loan repayment assistance/forgiveness program that incentivizes employment in the nursing home profession

> Avoid an Access to Care Crisis

Due to decades of underfunding and staffing shortages in LTC, we are facing a very real threat of Texas seniors not being able to access quality care in the near future. In a Fall 2021 survey of Texas long-term care facilities, 30% reported having to limit new admissions due to staffing shortages. Without adequate funding and without solutions to staffing shortages in Texas long-term care, facilities are unable to admit new residents in need.