Volume XXXI, Number 1
January 2016

Warren Tells House Committee that High Workforce Turnover, Low Wages Threaten Long Term Care

The Texas Legislature must take significant action ensure a quality workforce is available to care for nursing home residents in the future, THCA President and CEO Kevin Warren stated in testimony before the House Human Services Committee on December 15.

“Nursing facilities throughout Texas are struggling to recruit and retain quality staff with limited resources available in a Medicaid-reliant sector,” Warren told the committee. “Our provider members tell us that staff turnover is one of the biggest problems they face. They cannot pay dependable, dedicated nurses and nurse assistants their true value, so many quality employees leave the long term care setting for better paying jobs.”

Warren spoke at the invitation of the committee as it considered the first of its interim charges, which Speaker Joe Straus recently assigned them to study. The charge calls for the committee to “Study the ten-year anticipated growth, the geographic distribution, and the projected economic impact of aging Texans. Review state services and programs available to seniors, including independent living services, and determine the capacity and effectiveness of the programs. Determine if Texas is prepared for the increased demands of aging Texans.

Warren described for the committee why it is hard to keep good staff members working in long term care.

“We are seeing warning signs that the stress of delivering quality care is driving quality caregivers out of the profession,” he said. “The caregivers who work in nursing homes are seeing patients with higher levels of acuity, especially with the growth of those suffering from Alzheimer’s and other forms of dementia. They also find themselves spending more time on meeting extensive and sometimes duplicative state and federal regulations—time taken away from resident care.”

Warren also pointed out that a survey of THCA membership earlier this year indicated the top three challenges to improving staff retention are:

  • A lack of available workforce pool in the community
  • Wage competition with other healthcare sections; and
  • A lack of local available training programs for LVNs and RNs

Moreover, he said, “In March, providers must navigate the new landscape brought about by the rollout of Medicaid Managed Care for residents. HHSC has been very responsive and helpful when problems have arisen but it still adds to the uncertainty for facilities trying to stay above water.”

To address the greatest challenges facing long term care providers, Warren recommended the following:

  • Invest in the assurance that a capable and sufficient workforce is available for both current and future demand.
  • Ensure patient access continues under managed care by making permanent the protections provided under SB 7 in the 83rd Legislature. Nursing facilities that meet the requirements for Medicaid licensure should remain an option for all residents.
  • Consider adopting a needs based assessment before allocating new Medicaid beds for new facility construction.
  • Reform the process by which the state regulates nursing homes to be more equitable and predictable while still ensuring that seniors are protected.

The committee will issue a report on its charges before the next Legislative Session begins in January, 2017.

President’s Report


 Legislative Update

  • Warren Tells House Committee that High Workforce Turnover, Low Wages Threaten Long Term Care


 Commitment to Care

If you have any questions about the THCA C to C Initiative or would like to share your facilities successes please contact Gloria Bean-Williams at gbwilliams@txhca.org or call (512) 458-1257.


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